Provider Demographics
NPI:1265969638
Name:SHAMSIE, YOUSUF (DO)
Entity type:Individual
Prefix:
First Name:YOUSUF
Middle Name:
Last Name:SHAMSIE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EMBARCADERO CTR STE 1900
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-3723
Mailing Address - Country:US
Mailing Address - Phone:410-658-6791
Mailing Address - Fax:
Practice Address - Street 1:746 THE ALAMEDA STE 10
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-3178
Practice Address - Country:US
Practice Address - Phone:408-228-1020
Practice Address - Fax:408-228-1021
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2020-02312207Q00000X
390200000X
CA18448207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program