Healthcare Provider Details

I. General information

NPI: 1275794224
Provider Name (Legal Business Name): SAMMY DANIEL, DAVID EGHBALIEH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2008
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5805 SEPULVEDA BLVD STE 690
SHERMAN OAKS CA
91411-2522
US

IV. Provider business mailing address

5805 SEPULVEDA BLVD STE 690
SHERMAN OAKS CA
91411-2522
US

V. Phone/Fax

Practice location:
  • Phone: 818-900-6480
  • Fax: 818-900-6488
Mailing address:
  • Phone: 310-991-7266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberA133688
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: