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General NPI Number Information
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NPI Number | 1932297843
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Entity Type | Individual
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Provider Name | FRED SAMIMI M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 311 OAK RIDGE DR STE 1
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City | ROSEVILLE
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State | CA
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Zip | 95661-3427
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Country | US
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Telephone | 916-990-2828
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Fax | 866-728-8816
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Provider Business Mailing Address
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Address Line | 9108 LAGUNA MAIN ST STE 4
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City | ELK GROVE
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State | CA
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Zip | 95758-7450
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Country | US
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Telephone | 916-686-5566
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Fax | 866-728-8816
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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 | 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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