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General NPI Number Information
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NPI Number | 1033287412
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Entity Type | Individual
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Provider Name | BAHRAM SAMOUHA PHARM D
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Gender | Male
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 03/18/2010
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Provider Practice Location Address
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Address Line | 8722 W PICO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90035
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Country | US
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Telephone | 310-657-6999
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Fax | 310-657-7979
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Provider Business Mailing Address
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Address Line | 311 N PALM DR
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City | BEVERLY HILLS
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State | CA
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Zip | 90210
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Country | US
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Telephone | 310-273-2181
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Fax | 310-657-7979
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 45531
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License Number State | CA
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