Provider Demographics
NPI:1497121701
Name:GHOZLAND AND YOUSSEF ANESTHESIA MEDICAL GROUP INC
Entity Type:Organization
Organization Name:GHOZLAND AND YOUSSEF ANESTHESIA MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSEFF
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:310-434-0044
Mailing Address - Street 1:PO BOX 893520
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92589-3520
Mailing Address - Country:US
Mailing Address - Phone:310-434-0044
Mailing Address - Fax:310-434-0099
Practice Address - Street 1:1551 OCEAN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2108
Practice Address - Country:US
Practice Address - Phone:310-434-0044
Practice Address - Fax:310-434-0099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty