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NPI Code Detail

MEDICARE: MOLLY MECHAMMIL SAMAAN

MEDICARE: MOLLY MECHAMMIL SAMAAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist33762CA

General Provider Information

NPI Number : 1285259051
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY MECHAMMIL SAMAAN
Provider Business Mailing Address
First Line : 11900 W OLYMPIC BLVD STE 410
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1168
Country : US
Telephone Number : 888-225-1995
Fax Number :
Provider Business Practice Location Address
First Line : 11900 W OLYMPIC BLVD STE 410
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1168
Country : US
Telephone Number : 888-225-1995
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2020
Last Update Date : 08/11/2023

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Directions to “ MOLLY MECHAMMIL SAMAAN ” Practice Location

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