=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457745531
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMMAR M YOUSIF MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2015
-----------------------------------------------------
Last Update Date | 11/12/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9280 W SUNSET RD STE 100
-----------------------------------------------------
City | LAS VEGAS
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89148-4861
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-952-1251
-----------------------------------------------------
Fax | 702-952-1242
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 400 N STEPHANIE ST STE 300
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89014-6692
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-952-3350
-----------------------------------------------------
Fax | 702-952-3364
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | 20931
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------