Provider Demographics
NPI:1437127545
Name:HANALLA, YOUSSEF A (MD)
Entity Type:Individual
Prefix:DR
First Name:YOUSSEF
Middle Name:A
Last Name:HANALLA
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 1:7130 N MILLBROOK AVENUE
Mailing Address - Street 2:SUITE 112
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720
Mailing Address - Country:US
Mailing Address - Phone:559-450-5500
Mailing Address - Fax:559-450-5551
Practice Address - Street 1:4945 W CYPRESS AVENUE
Practice Address - Street 2:SUITE A
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277
Practice Address - Country:US
Practice Address - Phone:559-624-3100
Practice Address - Fax:559-635-4043
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA516772085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OOA516770OtherMEDICAL
G45654Medicare UPIN
CAOOA516770Medicare ID - Type Unspecified