Healthcare Provider Details

I. General information

NPI: 1386089407
Provider Name (Legal Business Name): YOUSSEF TAHIRI MD, MSC, FRCSC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2013
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9033 WILSHIRE BLVD STE 200
BEVERLY HILLS CA
90211-1836
US

IV. Provider business mailing address

9033 WILSHIRE BLVD STE 200
BEVERLY HILLS CA
90211-1836
US

V. Phone/Fax

Practice location:
  • Phone: 310-890-4802
  • Fax: 310-255-4476
Mailing address:
  • Phone: 310-890-4802
  • Fax: 310-255-4476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA141420
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: