Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | G80181 | CA |
N | 207R00000X | Internist | G80181 | CA |
N | 111NI0900X | Internist | G80181 | CA |
Y | 207RG0100X | Gastroenterologist | G80181 | CA |
N | 208200000X | Surgeon | G80181 | CA |
N | 208600000X | Surgeon | G80181 | CA |
NPI | 1720008899 |
---|---|
Provider Name | Sammy Saab |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 02/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G801810 | (05) | CA |
G34528 | (02) | CA |