Provider Demographics
NPI:1467618363
Name:BARSOUM, YASSER WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:YASSER
Middle Name:WILLIAM
Last Name:BARSOUM
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 1:1700 S COURT ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-4929
Mailing Address - Country:US
Mailing Address - Phone:559-697-6290
Mailing Address - Fax:559-697-6291
Practice Address - Street 1:1700 S COURT ST
Practice Address - Street 2:SUITE D
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-4929
Practice Address - Country:US
Practice Address - Phone:559-697-6290
Practice Address - Fax:559-697-6291
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV23178207RN0300X
CAA91481207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810012902Medicaid
WV4243231Medicare PIN