Organization
SAM GHALILI MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAM GHALILI M.D. (OWNER)
(213) 749-7110
Entity
Organization
Contact information
Practice address
2101 S SAN PEDRO ST, LOS ANGELES, CA 90011-1125
(213) 845-8766
(213) 745-8704
Mailing address
2101 S SAN PEDRO ST, LOS ANGELES, CA 90011-1125
(213) 845-8766
(213) 745-8704
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A88734
CA
208D00000X
General Practice Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A088734
—
CA
Enumeration date
12/04/2015
Last updated
09/21/2016
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