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NPI Code Detail

MEDICARE: YOUSEF ISSA GHANDOUR PT

MEDICARE: YOUSEF ISSA GHANDOUR PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT13475CA

General Provider Information

NPI Number : 1932213188
Entity Type Code : Individual
Provider Name (Legal Business Name) : YOUSEF ISSA GHANDOUR PT
Provider Business Mailing Address
First Line : 317 N EL CAMINO REAL
Second Line : STE 210
City : ENCINITAS
State : CA
Zip : 92024-2813
Country : US
Telephone Number : 760-634-0248
Fax Number : 760-634-1782
Provider Business Practice Location Address
First Line : 4435 EASTGATE MALL STE 120
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-1980
Country : US
Telephone Number : 858-587-8669
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2006
Last Update Date : 12/13/2018

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Directions to “ YOUSEF ISSA GHANDOUR PT” Practice Location

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