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General NPI Number Information
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NPI Number | 1346545142
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Entity Type | Individual
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Provider Name | SIAVASH AZADMANESH SAMIMI
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Gender | Male
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Dates
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Enumeration Date | 01/26/2011
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 183 E 8TH AVE
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City | CHICO
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State | CA
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Zip | 95926-2341
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Country | US
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Telephone | 530-891-6244
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Fax |
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Provider Business Mailing Address
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Address Line | 183 E 8TH AVE
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City | CHICO
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State | CA
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Zip | 95926-2341
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Country | US
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Telephone | 530-891-6244
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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 | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number | A135924
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number | MD2019-0725
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | A135924
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | MD2019-0725
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License Number State | NM
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Taxonomy #5
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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 | CA
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Taxonomy #6
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 321389
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License Number State | NY
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