Provider Demographics
NPI:1952337321
Name:ZAKY, AMAL YOUSSEF
Entity Type:Individual
Prefix:DR
First Name:AMAL
Middle Name:YOUSSEF
Last Name:ZAKY
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:AMAL
Other - Middle Name:YOUSSEF
Other - Last Name:ZAKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7648 SEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-6046
Mailing Address - Country:US
Mailing Address - Phone:323-587-1175
Mailing Address - Fax:323-587-7358
Practice Address - Street 1:7648 SEVILLE AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-6046
Practice Address - Country:US
Practice Address - Phone:323-587-1175
Practice Address - Fax:323-587-7358
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A384470174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A384470Medicaid
CAA88458Medicare UPIN