Provider Demographics
NPI:1699877365
Name:SAM SAEED ZAMANI M.D. PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:SAM SAEED ZAMANI M.D. PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAM SAEED
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-939-5599
Mailing Address - Street 1:112 LA CASA VIA
Mailing Address - Street 2:SUITE 320
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3091
Mailing Address - Country:US
Mailing Address - Phone:925-939-5599
Mailing Address - Fax:925-939-4099
Practice Address - Street 1:112 LA CASA VIA
Practice Address - Street 2:SUITE 320
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3091
Practice Address - Country:US
Practice Address - Phone:925-939-5599
Practice Address - Fax:925-939-4099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-02
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A6155515207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ01630ZMedicare PIN