MEDICARE: SAMPLEX A PROFESSIONAL CORPORATION

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	207RP1001X	Pulmonary Disease Physician

General Provider Information

NPI Number	:	1215890983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMPLEX A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	153 SPECKLED ALDER
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92618-1168
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3650 SOUTH ST STE 308
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90712-1518
Country	:	US
Telephone Number	:	562-633-2275
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	DR. SAMER MOGHADDAM
Credential	:	MD
Telephone Number	:	949-705-8485

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “SAMPLEX A PROFESSIONAL CORPORATION ” Practice Location

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