Individual
JAYSHREE HEMANT SAMPAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 EAST VALENCIA MESA DRIVE, FULLERTON, CA 92835
(714) 992-3978
Mailing address
PO BOX 4505, WOODLAND HILLS, CA 91365-4505
(818) 597-3800
(818) 879-8272
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
C42794
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C427940
—
CA
01
—
RHL136179
DEPT OF HEALTH
CA
Enumeration date
09/14/2006
Last updated
03/07/2023
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