Healthcare Provider Details

I. General information

NPI: 1437127545
Provider Name (Legal Business Name): YOUSSEF A HANALLA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4945 W CYPRESS AVENUE SUITE A
VISALIA CA
93277
US

IV. Provider business mailing address

7130 N MILLBROOK AVENUE SUITE 112
FRESNO CA
93720
US

V. Phone/Fax

Practice location:
  • Phone: 559-624-3100
  • Fax: 559-635-4043
Mailing address:
  • Phone: 559-450-5500
  • Fax: 559-450-5551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberA51677
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: