MEDICARE: DR. SAMER ALAITI 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	207N00000X	Dermatology Physician	A51530	CA

General Provider Information

NPI Number	:	1770591802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMER ALAITI MD

Provider Business Mailing Address
First Line	:	1100 S LA CIENEGA BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-2519
Country	:	US
Telephone Number	:	323-938-2626
Fax Number	:	323-938-2493

Provider Business Practice Location Address
First Line	:	6200 WILSHIRE BLVD
Second Line	:	SUITE 1502
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5801
Country	:	US
Telephone Number	:	323-938-2626
Fax Number	:	323-938-2493

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

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	06/18/2018

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