Healthcare Provider Details
I. General information
NPI: 1801572318
Provider Name (Legal Business Name): YOUSRA SAMIR ELSAYED GHOWEBA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/27/2023
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
730 WELCH RD FL 2
PALO ALTO CA
94304-1503
US
IV. Provider business mailing address
1501 N CAMPBELL AVE
TUCSON AZ
85724-0001
US
V. Phone/Fax
- Phone: 520-626-5652
- Fax:
- Phone: 520-401-7781
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | A211856 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | R80221 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: