Healthcare Provider Details

I. General information

NPI: 1144843962
Provider Name (Legal Business Name): PARGOL SAMANI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2020
Last Update Date: 06/01/2022
Certification Date: 06/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3927 WARING RD STE C
OCEANSIDE CA
92056-4458
US

IV. Provider business mailing address

3927 WARING RD STE C
OCEANSIDE CA
92056-4458
US

V. Phone/Fax

Practice location:
  • Phone: 619-703-7220
  • Fax: 619-703-7221
Mailing address:
  • Phone: 818-561-1026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PARGOL SAMANI
Title or Position: PRESIDENT
Credential: MD
Phone: 818-561-1026