Provider Demographics
NPI:1568714079
Name:YOUSSEFZADEH, BAVAND (DO)
Entity Type:Individual
Prefix:DR
First Name:BAVAND
Middle Name:
Last Name:YOUSSEFZADEH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18632 BEACH BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-2047
Mailing Address - Country:US
Mailing Address - Phone:714-962-3633
Mailing Address - Fax:714-962-3693
Practice Address - Street 1:18632 BEACH BLVD STE 100
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-2047
Practice Address - Country:US
Practice Address - Phone:714-962-3633
Practice Address - Fax:714-962-3693
Is Sole Proprietor?:No
Enumeration Date:2012-10-08
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A14047207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology