Provider Demographics
NPI:1184084865
Name:MOHAMMAD YOUSEF ALKHATIB MD INC
Entity type:Organization
Organization Name:MOHAMMAD YOUSEF ALKHATIB MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:Y
Authorized Official - Last Name:ALKHATIB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-619-7656
Mailing Address - Street 1:47750 ADAMS ST APT 1223
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-7107
Mailing Address - Country:US
Mailing Address - Phone:760-863-1592
Mailing Address - Fax:866-544-2050
Practice Address - Street 1:79405 HIGHWAY 111 STE 9-334
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-8300
Practice Address - Country:US
Practice Address - Phone:760-863-1592
Practice Address - Fax:866-544-2050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA117007207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty