Provider Demographics
NPI:1184939787
Name:RUHULLAH, YUSUF S (MD)
Entity type:Individual
Prefix:
First Name:YUSUF
Middle Name:S
Last Name:RUHULLAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:821 EAST 18TH STREET
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-4797
Mailing Address - Country:US
Mailing Address - Phone:307-632-2434
Mailing Address - Fax:307-634-3510
Practice Address - Street 1:1133 E STANLEY BLVD
Practice Address - Street 2:STE 117
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-4243
Practice Address - Country:US
Practice Address - Phone:307-632-2434
Practice Address - Fax:307-634-3510
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY9073A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine