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General NPI Number Information
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NPI Number | 1285749937
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Entity Type | Individual
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Provider Name | YOUSSEF BOULOS HADWEH M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 08/08/2012
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Provider Practice Location Address
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Address Line | 129 N 5TH ST
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City | CHOWCHILLA
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State | CA
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Zip | 93610-2820
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Country | US
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Telephone | 559-665-0275
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Fax | 559-665-7126
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Provider Business Mailing Address
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Address Line | 129 N 5TH ST
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City | CHOWCHILLA
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State | CA
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Zip | 93610-2820
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Country | US
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Telephone | 559-665-0275
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Fax | 559-665-7126
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G74536
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License Number State | CA
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