Healthcare Provider Details

I. General information

NPI: 1659337228
Provider Name (Legal Business Name): ZAHIDA A YOOSUFANI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 07/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 TORRANCE BLVD
REDONDO BEACH CA
90277-3413
US

IV. Provider business mailing address

6000 BUCKINGHAM PKWY UNIT 22
CULVER CITY CA
90230-6883
US

V. Phone/Fax

Practice location:
  • Phone: 310-316-0811
  • Fax: 310-543-9621
Mailing address:
  • Phone: 215-600-8933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberME-0071760
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberC050085
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License NumberME-0071760
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC050085
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME-0071760
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberC050085
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME-0071760
License Number StateFL
# 8
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberC050085
License Number StateCA
# 9
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberME-0071760
License Number StateFL
# 10
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberC050085
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: