Provider Demographics
NPI:1699749093
Name:DAHER, SAMIR FARAH (DC)
Entity type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:FARAH
Last Name:DAHER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 S BRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-1701
Mailing Address - Country:US
Mailing Address - Phone:818-507-5339
Mailing Address - Fax:818-246-2170
Practice Address - Street 1:319 S BRAND BLVD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1701
Practice Address - Country:US
Practice Address - Phone:818-507-5339
Practice Address - Fax:818-246-2170
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16112111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health