Provider Demographics
NPI:1730926312
Name:YOUNESSI MEDICAL PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:YOUNESSI MEDICAL PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNESSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-210-3388
Mailing Address - Street 1:8306 WILSHIRE BLVD # 673
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2304
Mailing Address - Country:US
Mailing Address - Phone:310-210-3388
Mailing Address - Fax:
Practice Address - Street 1:5400 NEWCASTLE AVE APT 7
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-2082
Practice Address - Country:US
Practice Address - Phone:310-210-3388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty