Healthcare Provider Details

I. General information

NPI: 1306044102
Provider Name (Legal Business Name): DAVID SAMIMI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 08/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 S GRAND AVE STE 200
LOS ANGELES CA
90015-3070
US

IV. Provider business mailing address

1513 S GRAND AVE STE 200
LOS ANGELES CA
90015-3070
US

V. Phone/Fax

Practice location:
  • Phone: 213-234-1000
  • Fax: 213-234-1001
Mailing address:
  • Phone: 213-234-1000
  • Fax: 213-234-1001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA115710
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA115710
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: