Provider Demographics
NPI:1457425282
Name:HAMAMJI, SAMI B (MD)
Entity type:Individual
Prefix:DR
First Name:SAMI
Middle Name:B
Last Name:HAMAMJI
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 1:1010 W LA VETA AVE STE 775
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4306
Mailing Address - Country:US
Mailing Address - Phone:714-541-5959
Mailing Address - Fax:714-835-9550
Practice Address - Street 1:1010 W LA VETA AVE STE 775
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4306
Practice Address - Country:US
Practice Address - Phone:714-541-5959
Practice Address - Fax:714-835-9550
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA49367208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A493670Medicaid
CAA049367OtherCA LICENSE
CAA049367OtherCA LICENSE
CAF13108Medicare UPIN