Provider Demographics
NPI:1790362309
Name:WASSEF, CYRIL ALEXANDER
Entity type:Individual
Prefix:
First Name:CYRIL
Middle Name:ALEXANDER
Last Name:WASSEF
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5204
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-0603
Mailing Address - Country:US
Mailing Address - Phone:623-889-3477
Mailing Address - Fax:623-889-3478
Practice Address - Street 1:750 N ESTRELLA PKWY STE 40
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-9279
Practice Address - Country:US
Practice Address - Phone:623-889-3477
Practice Address - Fax:623-889-3478
Is Sole Proprietor?:No
Enumeration Date:2021-03-28
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ011205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine