MEDICARE: SAM H. HESSAMI 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	207V00000X	Obstetrics & Gynecology Physician	G149086	CA
2	207VG0400X	Gynecology Physician	25MA06718800	NJ
3	207VG0400X	Gynecology Physician	209108	NY
4	207VF0040X	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	G149086	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
2	G149086	OTHER	CA	CALIFORNIA MEDICAL LICENSE

General Provider Information

NPI Number	:	1831167162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAM H. HESSAMI MD

Provider Business Mailing Address
First Line	:	400 N PEPPER AVE # 206
Second Line	:
City	:	COLTON
State	:	CA
Zip	:	92324-1801
Country	:	US
Telephone Number	:	909-580-2270
Fax Number	:	909-580-3289

Provider Business Practice Location Address
First Line	:	3501 S HARBOR BLVD STE 200
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-6940
Country	:	US
Telephone Number	:	949-284-4996
Fax Number	:	888-498-4129

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

Provider Enumeration Date	:	03/11/2006
Last Update Date	:	08/11/2025

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Directions to “ SAM H. HESSAMI MD” Practice Location

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