Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A043899 | CA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | A043899 | CA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | A043899 | CA |
NPI | 1467587824 |
---|---|
Provider Name | Soheil Samimi |
First Address | West Covina, CA 91793 |
Second Address | West Covina, CA 91790 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7180126 | (05) | CA |
A043899 | STATE OF CA LICENSE (01) | CA |
E64334 | (02) |