Provider Demographics
NPI:1285908707
Name:BAKHOUM, YOUSSEF Y (MD)
Entity type:Individual
Prefix:DR
First Name:YOUSSEF
Middle Name:Y
Last Name:BAKHOUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOSEPH
Other - Middle Name:
Other - Last Name:BAKHOUM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 3730
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93278-3730
Mailing Address - Country:US
Mailing Address - Phone:559-636-8071
Mailing Address - Fax:
Practice Address - Street 1:1837 W DOROTHEA AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-7363
Practice Address - Country:US
Practice Address - Phone:559-636-8071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41373208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
F64893Medicare UPIN