MEDICARE: SAMANTHA PARAGONA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WM0705X	Medical-Surgical Registered Nurse	RN2317178	MA
2	363LW0102X	Women's Health Nurse Practitioner	95028606	CA

General Provider Information

NPI Number	:	1184246746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA PARAGONA

Provider Business Mailing Address
First Line	:	213 PASEO DE SUENOS
Second Line	:
City	:	REDONDO BEACH
State	:	CA
Zip	:	90277-6560
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8383 WILSHIRE BLVD
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2425
Country	:	US
Telephone Number	:	310-855-2229
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2020
Last Update Date	:	07/10/2025

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