Provider Demographics
NPI:1104067628
Name:SAMSAMI, FARZIN (MD)
Entity type:Individual
Prefix:DR
First Name:FARZIN
Middle Name:
Last Name:SAMSAMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 PALM DR
Mailing Address - Street 2:APPT # 203
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-3319
Mailing Address - Country:US
Mailing Address - Phone:818-502-0769
Mailing Address - Fax:
Practice Address - Street 1:634 PALM DR
Practice Address - Street 2:APPT # 203
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91202-3319
Practice Address - Country:US
Practice Address - Phone:818-502-0769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA105428207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine