Provider Demographics
NPI:1790362309
Name:WASSEF, CYRIL ALEXANDER
Entity Type:Individual
Prefix:
First Name:CYRIL
Middle Name:ALEXANDER
Last Name:WASSEF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 N PALM CANYON DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4402
Mailing Address - Country:US
Mailing Address - Phone:623-570-9524
Mailing Address - Fax:
Practice Address - Street 1:1150 N PALM CANYON DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4402
Practice Address - Country:US
Practice Address - Phone:623-570-9524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program