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General NPI Number Information
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NPI Number | 1063886323
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Entity Type | Organization
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Legal Business Name | SAMAN FAKHERI MD INC
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 03/31/2024
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Provider Practice Location Address
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Address Line | 17075 DEVONSHIRE ST STE 201
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City | NORTHRIDGE
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State | CA
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Zip | 91325-5407
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Country | US
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Telephone | 818-923-5453
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Fax | 310-593-2521
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Provider Business Mailing Address
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Address Line | 17075 DEVONSHIRE ST STE 201
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City | NORTHRIDGE
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State | CA
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Zip | 91325-5407
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Country | US
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Telephone | 818-943-8299
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Fax | 310-953-2521
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAMAN FAKHERI
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Credential | M.D.
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Telephone | 818-943-8299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A107753
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License Number State | CA
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