Healthcare Provider Details

I. General information

NPI: 1356582183
Provider Name (Legal Business Name): SAMY YOUNIS MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2009
Last Update Date: 02/28/2024
Certification Date: 02/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 CORPORATE PARK STE 240
IRVINE CA
92606-3123
US

IV. Provider business mailing address

4050 BARRANCA PKWY SUITE 240
IRVINE CA
92604-7706
US

V. Phone/Fax

Practice location:
  • Phone: 949-451-9292
  • Fax: 949-451-9294
Mailing address:
  • Phone: 949-451-9292
  • Fax: 949-451-9294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA54855
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA045295
License Number StateCA

VIII. Authorized Official

Name: DR. SAMY AHMED YOUNIS
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 949-451-0845