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General NPI Number Information
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NPI Number | 1679338222
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Entity Type | Individual
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Provider Name | ROHAN SAMARTH
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Gender | Female
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Dates
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Enumeration Date | 02/13/2024
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Last Update Date | 02/13/2024
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Provider Practice Location Address
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Address Line | 122 E OLIVE AVE
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City | BURBANK
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State | CA
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Zip | 91502-1819
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Country | US
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Telephone | 818-557-0024
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Fax |
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Provider Business Mailing Address
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Address Line | 620 GLENWOOD RD APT B
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City | GLENDALE
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State | CA
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Zip | 91202-1586
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Country | US
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Telephone | 814-441-2007
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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