Provider Demographics
NPI:1649823444
Name:YOUSEF IREIFEJ MD INC
Entity type:Organization
Organization Name:YOUSEF IREIFEJ MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DUFFY
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-790-2263
Mailing Address - Street 1:5942 EDINGER AVE STE 113-165
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-1763
Mailing Address - Country:US
Mailing Address - Phone:714-642-4687
Mailing Address - Fax:
Practice Address - Street 1:5942 EDINGER AVE STE 113-165
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-1763
Practice Address - Country:US
Practice Address - Phone:714-642-4687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-20
Last Update Date:2019-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty