Provider Demographics
NPI:1184326928
Name:GHALEB, YOUSIF MANSOOR (OD)
Entity type:Individual
Prefix:DR
First Name:YOUSIF
Middle Name:MANSOOR
Last Name:GHALEB
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:4851 WILLIAMSON ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-3165
Mailing Address - Country:US
Mailing Address - Phone:313-707-2270
Mailing Address - Fax:
Practice Address - Street 1:5250 AUTO CLUB DR STE 200
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2619
Practice Address - Country:US
Practice Address - Phone:313-914-5591
Practice Address - Fax:313-982-9847
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4901005663152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist