Provider Demographics
NPI:1881736312
Name:YOUNES MEDICAL CORPORATION
Entity type:Organization
Organization Name:YOUNES MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE/BILLING MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-636-1336
Mailing Address - Street 1:36923 COOK ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-6073
Mailing Address - Country:US
Mailing Address - Phone:760-636-1336
Mailing Address - Fax:760-636-1335
Practice Address - Street 1:36923 COOK ST
Practice Address - Street 2:SUITE 103
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-6073
Practice Address - Country:US
Practice Address - Phone:760-636-1336
Practice Address - Fax:760-636-1335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94095261QI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ04702ZMedicare PIN