Provider Demographics
NPI:1386113348
Name:SAMIR B DAMANI MD INC
Entity type:Organization
Organization Name:SAMIR B DAMANI MD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:B
Authorized Official - Last Name:DAMANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-245-6775
Mailing Address - Street 1:9850 GENESEE AVE STE 650
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1231
Mailing Address - Country:US
Mailing Address - Phone:858-800-2480
Mailing Address - Fax:858-216-1908
Practice Address - Street 1:9850 GENESEE AVE STE 650
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1231
Practice Address - Country:US
Practice Address - Phone:858-800-2480
Practice Address - Fax:858-216-1908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-20
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty