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General NPI Number Information
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NPI Number | 1073066874
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Entity Type | Individual
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Provider Name | AMIN SAMADIAN
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Gender | Male
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Dates
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Enumeration Date | 07/27/2016
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Last Update Date | 04/26/2018
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Provider Practice Location Address
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Address Line | 23 ORINDA WAY STE 301
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City | ORINDA
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State | CA
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Zip | 94563-2520
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Country | US
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Telephone | 925-254-2360
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Fax | 925-254-7392
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Provider Business Mailing Address
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Address Line | 769 11TH AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-3614
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Country | US
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Telephone | 310-913-8242
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 100377
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License Number State | CA
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