Provider Demographics
NPI:1508334178
Name:ISKANDAR, YOUSSEF A
Entity Type:Individual
Prefix:
First Name:YOUSSEF
Middle Name:A
Last Name:ISKANDAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25922 SPENCER CT
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-3167
Mailing Address - Country:US
Mailing Address - Phone:312-468-6482
Mailing Address - Fax:
Practice Address - Street 1:7256 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-3410
Practice Address - Country:US
Practice Address - Phone:323-874-2507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79114183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty