Healthcare Provider Details

I. General information

NPI: 1942915822
Provider Name (Legal Business Name): YOUNIQUE MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2023
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 5TH ST STE 300
SANTA MONICA CA
90401-1433
US

IV. Provider business mailing address

1317 5TH ST STE 300
SANTA MONICA CA
90401-1433
US

V. Phone/Fax

Practice location:
  • Phone: 310-434-0044
  • Fax:
Mailing address:
  • Phone: 310-434-0044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARK M YOUSSEF
Title or Position: CEO
Credential: M. D.
Phone: 310-434-0044