Individual
DR. SAMUEL A DANESHVAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2020 SANTA MONICA BLVD, SUITE 220, SANTA MONICA, CA 90404-2023
(310) 595-5216
(310) 582-6222
Mailing address
6333 WILSHIRE BLVD, SUITE 410, LOS ANGELES, CA 90048-5702
(310) 339-7937
(323) 655-1991
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A98722
CA
207RC0000X
Cardiovascular Disease Physician
Primary
A98722
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1699940494
CCS PANELED PROVIDER
CA
05
—
1699940494
—
CA
Enumeration date
04/23/2008
Last updated
02/06/2014
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