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General NPI Number Information
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NPI Number | 1063033736
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Entity Type | Individual
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Provider Name | MICHELLE L YOUSEFZADEH DO
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Gender | Female
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Dates
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Enumeration Date | 05/04/2020
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 1301 20TH ST STE 110
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City | SANTA MONICA
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State | CA
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Zip | 90404-2096
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Country | US
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Telephone | 310-453-0419
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 49272
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City | LOS ANGELES
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State | CA
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Zip | 90049-0272
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Country | US
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Telephone | 310-729-3748
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 20A20969
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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