Healthcare Provider Details

I. General information

NPI: 1326716838
Provider Name (Legal Business Name): PETER YOUSIF
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14440 BURBANK BLVD
SHERMAN OAKS CA
91401-4823
US

IV. Provider business mailing address

14440 BURBANK BLVD
SHERMAN OAKS CA
91401-4823
US

V. Phone/Fax

Practice location:
  • Phone: 818-989-5422
  • Fax:
Mailing address:
  • Phone: 818-989-5422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH84596
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: