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General NPI Number Information
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NPI Number | 1356596233
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Entity Type | Individual
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Provider Name | SOHEIL SAMVATIAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/19/2008
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 661 W 1ST ST STE G
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City | TUSTIN
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State | CA
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Zip | 92780-2939
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Country | US
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Telephone | 714-665-9890
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Fax | 714-665-9890
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Provider Business Mailing Address
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Address Line | 661 W 1ST ST STE G
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City | TUSTIN
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State | CA
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Zip | 92780-2939
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Country | US
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Telephone | 714-665-9890
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Fax | 714-665-9891
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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 | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A105183
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | A105183
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | A105183
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License Number State | CA
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