Basic Information
Provider Information
NPI: 1457745531
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YOUSIF
FirstName: AMMAR
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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Mailing Information
Address1: 18000 STUDEBAKER RD STE 800
Address2:  
City: CERRITOS
State: CA
PostalCode: 907032671
CountryCode: US
TelephoneNumber: 5627353226
FaxNumber:  
Practice Location
Address1: 2911 N TENAYA WAY STE 210
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891280495
CountryCode: US
TelephoneNumber: 7023421244
FaxNumber: 7025772542
Other Information
ProviderEnumerationDate: 03/26/2015
LastUpdateDate: 08/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 08/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207RH0003X20931NVY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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