Provider Demographics
NPI:1366642191
Name:YOUSEFI, FAYSAL (MD)
Entity Type:Individual
Prefix:
First Name:FAYSAL
Middle Name:
Last Name:YOUSEFI
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 1:3022 S DURANGO DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-4440
Mailing Address - Country:US
Mailing Address - Phone:702-256-3637
Mailing Address - Fax:
Practice Address - Street 1:229 N PECOS RD STE 120
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7364
Practice Address - Country:US
Practice Address - Phone:702-629-7510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243240-1207RN0300X
NV20624207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology