Provider Demographics
NPI:1265612220
Name:SAMY YOUNIS MD
Entity type:Organization
Organization Name:SAMY YOUNIS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMY
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:YOUNIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-451-0845
Mailing Address - Street 1:4050 BARRANCA PKWY
Mailing Address - Street 2:SUITE 240
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-7706
Mailing Address - Country:US
Mailing Address - Phone:949-451-9292
Mailing Address - Fax:949-451-9294
Practice Address - Street 1:4050 BARRANCA PKWY
Practice Address - Street 2:SUITE 240
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-7706
Practice Address - Country:US
Practice Address - Phone:949-451-9292
Practice Address - Fax:949-451-9294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW14857Medicare PIN