Organization
SAMIR B. DAMANI MD INC
Active
Organization
SAMIR B. DAMANI MD INC
Active
Parent organization
MD REVOLUTION
Other names
MD Revolution
Organization subpart
Yes
Provider details
NPI number
Legal business name
MD REVOLUTION
Authorized official
DR. SAMIR B DAMANI MD (PHYSICIAN)
(858) 847-5064
Entity
Organization
Contact information
Practice address
9850 GENESEE AVE, SUITE 730, LA JOLLA, CA 92037
(858) 847-5064
(858) 433-4099
Mailing address
9850 GENESEE AVE, SUITE 730, LA JOLLA, CA 92037
(858) 847-5064
(858) 433-4099
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A88989
CA
207RC0000X
Cardiovascular Disease Physician
Primary
A88989
CA
207RC0000X
Cardiovascular Disease Physician
—
—
207SG0201X
Clinical Genetics (M.D.) Physician
A88989
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A889890
—
CA
Enumeration date
02/16/2012
Last updated
06/17/2013
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