Provider Information for 1164096152
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SAMIA LUCINDA YESUFU
Sex: Female
NPI: 1164096152
Last Updated: 2024-09-20
Certification Date: 2024-09-20
Certification Date: 2024-09-20
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1164096152 | ||||||||||||
| Enumeration Date | 2021-05-14 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 12021 WILMINGTON AVE BLDG 182ND LOS ANGELES, CA 90059-3019 United States Phone: 424-454-5000 | Fax: | ||||||||||||
| Primary Practice Address | 12021 WILMINGTON AVE BLDG 182ND LOS ANGELES, CA 90059-3019 United States Phone: 424-454-5000 | Fax: | ||||||||||||
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