Basic Information
| Provider Information | |||||||||
| NPI: | 1366642191 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YOUSEFI | ||||||||
| FirstName: | FAYSAL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3022 S DURANGO DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | LAS VEGAS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 891174440 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7022563637 | ||||||||
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| Practice Location | |||||||||
| Address1: | 229 N PECOS RD STE 120 | ||||||||
| Address2: | |||||||||
| City: | HENDERSON | ||||||||
| State: | NV | ||||||||
| PostalCode: | 890747364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7026297510 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2007 | ||||||||
| LastUpdateDate: | 02/22/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 243240-1 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207RN0300X | 20624 | NV | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.