Provider Demographics
NPI:1083255616
Name:YOUNIQUE SURGERY CENTER
Entity Type:Organization
Organization Name:YOUNIQUE SURGERY CENTER
Other - Org Name:YOUNIQUE SURGERY CENTER SANTA MONICA
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER MANAGING EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:MAGDY
Authorized Official - Last Name:YOUSSEF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-434-0044
Mailing Address - Street 1:1317 5TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-1433
Mailing Address - Country:US
Mailing Address - Phone:310-434-0099
Mailing Address - Fax:714-464-2222
Practice Address - Street 1:1317 5TH ST STE 301
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-1459
Practice Address - Country:US
Practice Address - Phone:310-434-0099
Practice Address - Fax:714-464-2222
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YOUNIQUE SURGERY CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-04
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1317OtherLICENSE