Healthcare Provider Details

I. General information

NPI: 1932421625
Provider Name (Legal Business Name): SAMUEL HOU M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2010
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S BUENA VISTA ST
BURBANK CA
91505-4809
US

IV. Provider business mailing address

4100 VALLEY SPRING DR DEPARTMENT OF RADIOLOGICAL SCIENCES
WESTLAKE VILLAGE CA
91362-4264
US

V. Phone/Fax

Practice location:
  • Phone: 818-847-6049
  • Fax: 818-847-4842
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA97972
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberA97972
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: