Provider Demographics
NPI:1780660902
Name:YOUSSEFI, BIJAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BIJAN
Middle Name:
Last Name:YOUSSEFI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 S CARLIN SPRINGS RD
Mailing Address - Street 2:SUIT 402
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-1064
Mailing Address - Country:US
Mailing Address - Phone:703-931-8877
Mailing Address - Fax:703-931-0848
Practice Address - Street 1:611 S CARLIN SPRINGS RD
Practice Address - Street 2:SUITE 402
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-1064
Practice Address - Country:US
Practice Address - Phone:703-931-8877
Practice Address - Fax:703-931-0848
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2010-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101031500207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
25318OtherMAMSI MDIPA OC
VA6398502Medicaid
9645OtherCAREFIRST
25318OtherMAMSI MDIPA OC
409465Medicare ID - Type Unspecified