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General NPI Number Information
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NPI Number | 1275794224
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Entity Type | Individual
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Provider Name | SAMMY DANIEL, DAVID EGHBALIEH M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 19950 RINALDI ST # 101D
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City | PORTER RANCH
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State | CA
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Zip | 91326-4141
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Country | US
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Telephone | 747-999-6827
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Fax | 818-350-0555
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Provider Business Mailing Address
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Address Line | 1530 CAMDEN AVE SUITE 403
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City | LOS ANGELES
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State | CA
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Zip | 90025-8010
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Country | US
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Telephone | 310-991-7266
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | A133688
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License Number State | CA
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