Provider Demographics
NPI:1700335700
Name:YOUSSEF, MAREYA ATEF (PHARMD)
Entity Type:Individual
Prefix:
First Name:MAREYA
Middle Name:ATEF
Last Name:YOUSSEF
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11011 ALONDRA BLVD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-6202
Mailing Address - Country:US
Mailing Address - Phone:562-547-1743
Mailing Address - Fax:
Practice Address - Street 1:11011 ALONDRA BLVD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-6202
Practice Address - Country:US
Practice Address - Phone:562-547-1743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-02
Last Update Date:2016-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA75118183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist