Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A71411 | CA |
NPI | 1013954908 |
---|---|
Provider Name | Dr. Joseph A Samady |
First Address | Oceanside, CA 92056-4522 |
Second Address | Oceanside, CA 92056-4522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 10/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
070015116 | RAILROAD MEDICARE (01) | CA |
H17544 | (02) | CA |