MEDICARE: SAMIRAH ALAM

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
1	106H00000X	Marriage & Family Therapist	161640	CA

General Provider Information

NPI Number	:	1891641783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMIRAH ALAM

Provider Business Mailing Address
First Line	:	4839 W 115TH ST
Second Line	:
City	:	HAWTHORNE
State	:	CA
Zip	:	90250-2002
Country	:	US
Telephone Number	:	310-462-9452
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 N SEPULVEDA BLVD
Second Line	:
City	:	MANHATTAN BEACH
State	:	CA
Zip	:	90266-5972
Country	:	US
Telephone Number	:	925-282-1778
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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Directions to “ SAMIRAH ALAM ” Practice Location

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