Healthcare Provider Details

I. General information

NPI: 1962104976
Provider Name (Legal Business Name): PEYMAN YOUNESI MD PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 COHASSET RD
CHICO CA
95926-2211
US

IV. Provider business mailing address

6136 170TH ST APT M4
FRESH MEADOWS NY
11365-1957
US

V. Phone/Fax

Practice location:
  • Phone: 530-343-5595
  • Fax:
Mailing address:
  • Phone: 718-709-0940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PEYMAN E YOUNESI
Title or Position: OWNER
Credential: MD
Phone: 718-709-0940