Provider Demographics
NPI:1043277700
Name:EL-ASYOUTY, SHERIF (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERIF
Middle Name:
Last Name:EL-ASYOUTY
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:PO BOX 30252
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93130-0252
Mailing Address - Country:US
Mailing Address - Phone:805-884-4989
Mailing Address - Fax:
Practice Address - Street 1:3 W CARRILLO ST
Practice Address - Street 2:SUITE 217
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-3283
Practice Address - Country:US
Practice Address - Phone:805-884-4989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82909103T00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA82909Medicare ID - Type Unspecified