Provider Demographics
NPI:1184517310
Name:YOUSSEF, HANY RAOUF SR
Entity type:Individual
Prefix:MR
First Name:HANY
Middle Name:RAOUF
Last Name:YOUSSEF
Suffix:SR
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:HANY
Other - Middle Name:RAOUF
Other - Last Name:YOUSSEF
Other - Suffix:SR
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3706 BILBERRY RD
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92407-9090
Mailing Address - Country:US
Mailing Address - Phone:714-499-5159
Mailing Address - Fax:
Practice Address - Street 1:3706 BILBERRY RD
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92407-9090
Practice Address - Country:US
Practice Address - Phone:714-499-5159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver