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General NPI Number Information
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NPI Number | 1104379072
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Entity Type | Individual
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Provider Name | DR. BESHOY SAMY
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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 | 07/27/2016
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Provider Practice Location Address
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Address Line | 1645 E 103RD ST
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City | LOS ANGELES
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State | CA
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Zip | 90002-2923
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Country | US
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Telephone | 323-564-5787
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Fax |
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Provider Business Mailing Address
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Address Line | 1928 18TH ST APT A
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City | SANTA MONICA
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State | CA
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Zip | 90404-4736
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Country | US
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Telephone | 310-302-7548
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 64992
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License Number State | CA
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