Provider Demographics
NPI:1518158336
Name:YOUSSEF HADWEH, M.D.
Entity Type:Organization
Organization Name:YOUSSEF HADWEH, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUSSEF
Authorized Official - Middle Name:B
Authorized Official - Last Name:HADWEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-665-0275
Mailing Address - Street 1:129 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:CHOWCHILLA
Mailing Address - State:CA
Mailing Address - Zip Code:93610-2820
Mailing Address - Country:US
Mailing Address - Phone:559-665-0275
Mailing Address - Fax:559-665-7126
Practice Address - Street 1:129 N 5TH ST
Practice Address - Street 2:
Practice Address - City:CHOWCHILLA
Practice Address - State:CA
Practice Address - Zip Code:93610-2820
Practice Address - Country:US
Practice Address - Phone:559-665-0275
Practice Address - Fax:559-665-7126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG74536261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARHM53925FMedicaid
CARHM53925FMedicaid
CA553925FMedicare Oscar/Certification