Healthcare Provider Details

I. General information

NPI: 1053812073
Provider Name (Legal Business Name): DR. JOSEPH MAKRAM YOUSSEF
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2018
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11162 LOS ALAMITOS BLVD
LOS ALAMITOS CA
90720-3621
US

IV. Provider business mailing address

16835 ALGONQUIN ST
HUNTINGTON BEACH CA
92649-3810
US

V. Phone/Fax

Practice location:
  • Phone: 562-598-8604
  • Fax:
Mailing address:
  • Phone: 888-700-6623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number104638
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: