# SAMAN GHALILI MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366735813
- **Authorized official:** DR. SAMAN GHALILI MD (CEO)
- **Authorized official phone:** (213) 749-7110

## Contact information

- **Practice address:** 2101 S SAN PEDRO ST, LOS ANGELES, CA 90011-1125
- **Practice address phone:** (213) 745-8766
- **Mailing address:** 2101 S SAN PEDRO ST, LOS ANGELES, CA 90011-1125
- **Mailing address phone:** (213) 745-8766

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | A88734 | CA | — |
| 208D00000X | General Practice Physician | A88734 | CA | Yes |
| 261QU0200X | Urgent Care Clinic/Center | A88734 | CA | — |

## Other

- **Enumeration date:** 05/17/2011
- **Last updated:** 10/30/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00A887340 | — | CA |