Provider Demographics
NPI:1972606937
Name:YOUSIF, MAHA A (PHD DMD)
Entity Type:Individual
Prefix:
First Name:MAHA
Middle Name:A
Last Name:YOUSIF
Suffix:
Gender:F
Credentials:PHD DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29809 SANTA MARGARITA PARKWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688
Mailing Address - Country:US
Mailing Address - Phone:949-216-9800
Mailing Address - Fax:949-216-9801
Practice Address - Street 1:29809 SANTA MARGARITA PARKWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:RANCHO SANTA MARGARITA
Practice Address - State:CA
Practice Address - Zip Code:92688
Practice Address - Country:US
Practice Address - Phone:949-216-9800
Practice Address - Fax:949-216-9801
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA508711223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics