Provider Demographics
NPI:1922188259
Name:LALEZARIAN, YOUSSEF (MD)
Entity type:Individual
Prefix:DR
First Name:YOUSSEF
Middle Name:
Last Name:LALEZARIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 S LAYTON DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-3035
Mailing Address - Country:US
Mailing Address - Phone:320-472-8525
Mailing Address - Fax:
Practice Address - Street 1:1740 S LOS ANGELES ST STE 104
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-3631
Practice Address - Country:US
Practice Address - Phone:213-742-7777
Practice Address - Fax:213-742-0808
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38247207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A382470Medicaid