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General NPI Number Information
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NPI Number | 1356958854
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Entity Type | Individual
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Provider Name | SAMY HAMDAN OTR/L
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Gender | Male
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Dates
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Enumeration Date | 09/29/2020
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Last Update Date | 09/29/2020
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Provider Practice Location Address
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Address Line | 585 NUT TREE CT
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City | VACAVILLE
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State | CA
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Zip | 95687-3353
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Country | US
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Telephone | 707-449-8081
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 BLUE OAKS BLVD APT 532
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City | ROSEVILLE
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State | CA
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Zip | 95747-8441
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Country | US
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Telephone | 951-329-0552
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 21642
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License Number State | CA
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