Provider Demographics
NPI:1215257894
Name:SABOUNCHI, SAMAN (MD)
Entity type:Individual
Prefix:DR
First Name:SAMAN
Middle Name:
Last Name:SABOUNCHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 MORSE AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-3653
Mailing Address - Country:US
Mailing Address - Phone:832-618-8479
Mailing Address - Fax:
Practice Address - Street 1:1355 CLAYTON RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-4307
Practice Address - Country:US
Practice Address - Phone:832-618-8479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10036779207R00000X
NY292859207RG0300X
CAA124796207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine