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General NPI Number Information
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NPI Number | 1295700151
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Entity Type | Organization
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Legal Business Name | DAVID YOUSSEFI DMD INC
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 08/15/2008
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Provider Practice Location Address
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Address Line | 2428 SANTA MONICA BLVD STE 403
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City | SANTA MONICA
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State | CA
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Zip | 90404
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Country | US
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Telephone | 310-696-6996
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Fax | 310-696-0602
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Provider Business Mailing Address
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Address Line | 2428 SANTA MONICA BLVD #403
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City | SANTA MONICA
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State | CA
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Zip | 90404
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Country | US
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Telephone | 310-696-6996
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Fax | 310-696-0602
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | DR. DAVID YOUSSEFI
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Credential | DMD FAGD
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Telephone | 310-696-6996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 45066
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License Number State | CA
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