Samra Laboratory Service, Inc.

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

A85846 Issued in CA

Legal business name

SAMRA LABORATORY SERVICE, INC.

Practice address

1730 W Olympic Blvd
Ste 101
Los Angeles, CA 90015-1019

Phone

(213) 384-1424

Fax

(213) 384-1101

NPI assigned

Oct 16, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kesung Kwak, D.C.

Title

President

Phone

(213) 384-1424

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• UNIMED IMAGING CENTER Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256083200000",
    "number": "1033444567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 W OLYMPIC BLVD",
            "address_2": "STE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900151019",
            "telephone_number": "213-384-1424",
            "fax_number": "213-384-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 W OLYMPIC BLVD",
            "address_2": "STE 101",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900151019",
            "telephone_number": "213-384-1424",
            "fax_number": "213-384-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMRA LABORATORY SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-16",
        "last_updated": "2009-10-21",
        "status": "A",
        "authorized_official_last_name": "KWAK",
        "authorized_official_first_name": "KESUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "213-384-1424",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "CA",
            "license": "A85846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA CHIROPRACTIC BOARD",
            "identifier": "DC30810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UNIMED IMAGING CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Sean Sampson, M.D.
• Steven Elliott Sampson, D.O.
• Terence Sampson, ACSW
• Samra Acupuncture Spinal Center, Inc.
• Samra Hamsoa, Inc.
• Samra University
• Karen Samra
• Nathan Sleeth Samras, M.D.
• Sams Hospice Care, Inc.
• Clarence M Sams

• Radiology Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Radiology Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.