Provider Demographics
NPI:1194981027
Name:BAWA, YUSEF SOHAIL (RCP, RN)
Entity type:Individual
Prefix:MR
First Name:YUSEF
Middle Name:SOHAIL
Last Name:BAWA
Suffix:
Gender:M
Credentials:RCP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30374 CEDAR OAK LN
Mailing Address - Street 2:
Mailing Address - City:CASTAIC
Mailing Address - State:CA
Mailing Address - Zip Code:91384-4775
Mailing Address - Country:US
Mailing Address - Phone:661-295-9753
Mailing Address - Fax:661-295-9753
Practice Address - Street 1:30374 CEDAR OAK LN
Practice Address - Street 2:
Practice Address - City:CASTAIC
Practice Address - State:CA
Practice Address - Zip Code:91384-4775
Practice Address - Country:US
Practice Address - Phone:661-295-9753
Practice Address - Fax:661-295-9753
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA553651163W00000X
CA000160332278C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No2278C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedCritical Care