Provider Demographics
NPI:1760668255
Name:YOUSEF, KAMAL (RPH)
Entity Type:Individual
Prefix:MR
First Name:KAMAL
Middle Name:
Last Name:YOUSEF
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:YOUSEF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:401 N VINCENT AVE
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-3907
Mailing Address - Country:US
Mailing Address - Phone:626-962-1061
Mailing Address - Fax:626-962-1157
Practice Address - Street 1:401 N VINCENT AVE
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-3907
Practice Address - Country:US
Practice Address - Phone:626-962-1061
Practice Address - Fax:626-962-1157
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40571183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA40571OtherPHARMACIST LICENSE #