Healthcare Provider Details

I. General information

NPI: 1801055900
Provider Name (Legal Business Name): SHERVIN YOUSEFIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2008
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2204 GRANT RD STE 103
MOUNTAIN VIEW CA
94040-3877
US

IV. Provider business mailing address

2204 GRANT RD STE 103
MOUNTAIN VIEW CA
94040-3877
US

V. Phone/Fax

Practice location:
  • Phone: 650-967-8841
  • Fax: 650-967-8812
Mailing address:
  • Phone: 650-967-8841
  • Fax: 650-967-8812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberA125229
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: