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General NPI Number Information
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NPI Number | 1992231112
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Entity Type | Organization
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Legal Business Name | SAMER KANAAN MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 05/08/2017
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Last Update Date | 05/08/2017
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Provider Practice Location Address
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Address Line | 27451 LOS ALTOS, SUITE 290
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City | MISSION VIEJO
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State | CA
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Zip | 92691
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Country | US
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Telephone | 949-444-5864
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Fax | 949-258-5863
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Provider Business Mailing Address
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Address Line | 30732 PASEO ELEGANCIA
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City | SAN JUAN CAPO
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State | CA
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Zip | 92675-5426
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Country | US
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Telephone | 269-910-8059
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Fax |
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Authorized Official
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Title or Position | MD
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Name | LINA KANAAN
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Credential |
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Telephone | 269-910-8058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | A87174
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License Number State | CA
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