Healthcare Provider Details

I. General information

NPI: 1760895247
Provider Name (Legal Business Name): EHAB YOUSSEIF
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2014
Last Update Date: 06/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40742 OAKMONT CT
PALMDALE CA
93551-5641
US

IV. Provider business mailing address

40742 OAKMONT CT
PALMDALE CA
93551-5641
US

V. Phone/Fax

Practice location:
  • Phone: 760-375-0223
  • Fax: 760-375-6733
Mailing address:
  • Phone: 760-375-0223
  • Fax: 760-375-6733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number65378
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: