Individual
DR. ABDUL SAMAD MASOUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
555 W COMPTON BLVD STE 104, COMPTON, CA 90220-3099
(310) 639-7200
(310) 639-0200
Mailing address
555 W COMPTON BLVD STE 104, COMPTON, CA 90220-3099
(310) 639-7200
(310) 639-0200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A48404
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A484040
—
CA
01
—
A48404
MEDICAL LICENSE #
CA
01
—
P00121487
CHAMPUS #
CA
01
—
ZZZ03316Z
BLUE SHEILD #
CA
Enumeration date
11/09/2006
Last updated
07/09/2007
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