Healthcare Provider Details

I. General information

NPI: 1194111799
Provider Name (Legal Business Name): SAMAN SETAREH-SHENAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 WILSHIRE BLVD STE 507
BEVERLY HILLS CA
90210-6150
US

IV. Provider business mailing address

9301 WILSHIRE BLVD STE 507
BEVERLY HILLS CA
90210-6150
US

V. Phone/Fax

Practice location:
  • Phone: 310-424-5750
  • Fax: 310-721-9339
Mailing address:
  • Phone: 310-424-5750
  • Fax: 310-721-9339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberA170539
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA170539
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA170539
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: