Provider Demographics
NPI:1386018687
Name:TARAZI, RIYAD YOUSSEF (MD)
Entity Type:Individual
Prefix:DR
First Name:RIYAD
Middle Name:YOUSSEF
Last Name:TARAZI
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 1:9120 JUDICIAL DR
Mailing Address - Street 2:APT 7522
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-6700
Mailing Address - Country:US
Mailing Address - Phone:619-228-3929
Mailing Address - Fax:
Practice Address - Street 1:9120 JUDICIAL DR
Practice Address - Street 2:APT 7522
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-6700
Practice Address - Country:US
Practice Address - Phone:619-228-3929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA46205208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)