Provider Demographics
NPI:1083693915
Name:MEHRABI, YOUSEF (MD)
Entity Type:Individual
Prefix:
First Name:YOUSEF
Middle Name:
Last Name:MEHRABI
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 1:16030 VENTURA BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4453
Mailing Address - Country:US
Mailing Address - Phone:818-609-9997
Mailing Address - Fax:818-609-9987
Practice Address - Street 1:16030 VENTURA BLVD STE 140
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4453
Practice Address - Country:US
Practice Address - Phone:818-609-9997
Practice Address - Fax:818-609-9987
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33919208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0441007Medicaid