Provider Demographics
NPI:1194111799
Name:SETAREH-SHENAS, SAMAN (MD)
Entity type:Individual
Prefix:DR
First Name:SAMAN
Middle Name:
Last Name:SETAREH-SHENAS
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 1:8631 W 3RD ST STE 540
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5909
Mailing Address - Country:US
Mailing Address - Phone:310-424-5750
Mailing Address - Fax:310-721-9339
Practice Address - Street 1:8631 W 3RD ST STE 540
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5909
Practice Address - Country:US
Practice Address - Phone:310-424-5750
Practice Address - Fax:310-721-9339
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA170539207R00000X, 207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology