Healthcare Provider Details

I. General information

NPI: 1831167162
Provider Name (Legal Business Name): SAM H. HESSAMI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2006
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 S HARBOR BLVD STE 200
SANTA ANA CA
92704-6940
US

IV. Provider business mailing address

400 N PEPPER AVE # 206
COLTON CA
92324-1801
US

V. Phone/Fax

Practice location:
  • Phone: 949-284-4996
  • Fax: 888-498-4129
Mailing address:
  • Phone: 909-580-2270
  • Fax: 909-580-3289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG149086
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number25MA06718800
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number209108
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberG149086
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: