=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124433198
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YAZAN SAMHOURI MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/27/2014
-----------------------------------------------------
Last Update Date | 09/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2946 E. BANNER GATEWAY DR.
-----------------------------------------------------
City | GILBERT
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85234
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-256-6444
-----------------------------------------------------
Fax | 480-256-3682
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2946 E. BANNER GATEWAY DR.
-----------------------------------------------------
City | GILBERT
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85234
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 480-256-6444
-----------------------------------------------------
Fax | 480-256-3682
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | MD475066
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | 75223
-----------------------------------------------------
License Number State | AZ
-----------------------------------------------------