Healthcare Provider Details

I. General information

NPI: 1164718896
Provider Name (Legal Business Name): MIRELLA YOUNES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3622 W PACKWOOD AVE
VISALIA CA
93277-5010
US

IV. Provider business mailing address

3622 W PACKWOOD AVE
VISALIA CA
93277-5010
US

V. Phone/Fax

Practice location:
  • Phone: 559-382-3820
  • Fax: 559-224-1012
Mailing address:
  • Phone: 559-382-3820
  • Fax: 559-224-1012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA127901
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: