Provider Demographics
NPI:1285715466
Name:YOUSEFIPOUR, RAMONA (DDS)
Entity type:Individual
Prefix:DR
First Name:RAMONA
Middle Name:
Last Name:YOUSEFIPOUR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-1684
Mailing Address - Country:US
Mailing Address - Phone:925-625-2616
Mailing Address - Fax:925-625-6219
Practice Address - Street 1:2817 MAIN ST
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:CA
Practice Address - Zip Code:94561-1684
Practice Address - Country:US
Practice Address - Phone:925-625-2616
Practice Address - Fax:925-625-6219
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA456321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice