Healthcare Provider Details

I. General information

NPI: 1366650608
Provider Name (Legal Business Name): ASHRAF E. YOUSSEF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ASHRAF E. YOUSSEF M.D.

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WASC STATE PRISON
WASCO CA
93280-8800
US

IV. Provider business mailing address

PO BOX 8800
WASCO CA
93280-8800
US

V. Phone/Fax

Practice location:
  • Phone: 661-758-8400
  • Fax: 661-758-7088
Mailing address:
  • Phone: 661-758-8400
  • Fax: 661-758-7088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA77629
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: