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Individual
DR. SAM S KHORSANDI
Active
Individual
DR. SAM S KHORSANDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
36257
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B3625701
—
CA
Enumeration date
03/08/2007
Last updated
07/09/2007
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