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General NPI Number Information
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NPI Number | 1740429588
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Entity Type | Organization
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Legal Business Name | AFSHIN SAMET MD PROF CORP
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Dates
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Enumeration Date | 02/18/2009
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Last Update Date | 03/03/2009
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Provider Practice Location Address
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Address Line | 1429 E THOUSAND OAKS BLVD SUITE 101
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-2801
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Country | US
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Telephone | 805-277-2437
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Fax | 805-277-2437
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Provider Business Mailing Address
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Address Line | PO BOX 390005
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City | SAN DIEGO
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State | CA
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Zip | 92149-0005
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Country | US
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Telephone | 619-746-6530
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Fax | 619-746-6528
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Authorized Official
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Title or Position | OWNER
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Name | DR. AFSHIN SAMET
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Credential | MD
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Telephone | 805-277-2437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0036364
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A54105
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License Number State | CA
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