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General NPI Number Information
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NPI Number | 1700926920
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Entity Type | Organization
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Legal Business Name | FRED R SAMIMI, MD, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8765 CENTER PKWY #D
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City | SACRAMENTO
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State | CA
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Zip | 95823-7682
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Country | US
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Telephone | 209-575-4575
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4398
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City | MODESTO
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State | CA
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Zip | 95352-4398
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Country | US
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Telephone | 209-575-4575
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRED R SAMIMI
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Credential | MD
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Telephone | 209-575-4575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | A83265
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License Number State | CA
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