Healthcare Provider Details

I. General information

NPI: 1336514546
Provider Name (Legal Business Name): SAMY SHAROBEEM, M D INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2015
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N ROBERTSON BLVD STE 150
BEVERLY HILLS CA
90211-2171
US

IV. Provider business mailing address

8549 WILSHIRE BLVD STE 1414
BEVERLY HILLS CA
90211-3104
US

V. Phone/Fax

Practice location:
  • Phone: 310-203-0222
  • Fax: 310-652-4053
Mailing address:
  • Phone: 310-203-0222
  • Fax: 310-652-4053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: SAMY SHAROBEEM
Title or Position: OFFICE MANAGER
Credential:
Phone: 310-203-0222