Provider Demographics
NPI:1548490568
Name:YOUSSEF, SHERRY (MD)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:YOUSSEF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:WASEF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5475 E LA PALMA AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-2075
Mailing Address - Country:US
Mailing Address - Phone:714-279-6204
Mailing Address - Fax:
Practice Address - Street 1:5475 E LA PALMA AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-2075
Practice Address - Country:US
Practice Address - Phone:714-279-6204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA 126357207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program