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General NPI Number Information
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NPI Number | 1659391258
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Entity Type | Organization
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Legal Business Name | ANDRE YOUSEFIA, M.D., INC.
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 227 W JANSS RD SUITE 100
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-1848
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Country | US
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Telephone | 805-230-2333
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Fax | 805-230-2335
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Provider Business Mailing Address
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Address Line | 1336 N MOORPARK RD #288
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-5224
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Country | US
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Telephone | 805-230-2333
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Fax | 805-230-2335
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDRE YOUSEFIA
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Credential | M.D.
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Telephone | 805-230-2333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A72667
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License Number State | CA
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