MEDICARE: DR. SAMUEL SAEED FEIZI MD

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	207R00000X	Internal Medicine Physician	G81831	CA
2	207RN0300X	Nephrology Physician	G56373	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356389274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMUEL SAEED FEIZI MD

Provider Business Mailing Address
First Line	:	18406 ROSCOE BLVD
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91325-4107
Country	:	US
Telephone Number	:	818-885-5480
Fax Number	:	818-885-5430

Provider Business Practice Location Address
First Line	:	18406 ROSCOE BLVD
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91325-4107
Country	:	US
Telephone Number	:	818-885-5480
Fax Number	:	818-885-5430

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

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	01/11/2011

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