Provider Demographics
NPI:1679580880
Name:ISKANDER, MONA YOUSSEF (MD)
Entity Type:Individual
Prefix:MRS
First Name:MONA
Middle Name:YOUSSEF
Last Name:ISKANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1901 FLOURNOY RD
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-2532
Mailing Address - Country:US
Mailing Address - Phone:310-546-6763
Mailing Address - Fax:310-546-6763
Practice Address - Street 1:4477 W 118TH ST
Practice Address - Street 2:SUITE 301
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-2255
Practice Address - Country:US
Practice Address - Phone:310-978-8026
Practice Address - Fax:310-978-1408
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39011208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A390110OtherBLUE SHIELD
CA00A390110Medicaid
CA00A390110OtherCAL CHILDRENS SVCS OF LA