Individual provider Active NPI

Sean Samsami, PHARM D

  • Pharmacist
  • Palmdale, CA
National Provider Identifier
1083274658
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
79419 Issued in CA
Practice address
39440 10TH St W
Palmdale, CA 93551-3747
Phone
(661) 265-7361
NPI assigned
Jun 17, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 79419 CA Primary

Addresses

Primary practice location

39440 10TH St W
Palmdale, CA 93551-3747

Mailing address

15119 Burbank Blvd Apt 9
Van Nuys, CA 91411-3564
Phone (310) 806-0198

Other practice location 1

58133 29 Palms Hwy
Yucca Valley, CA 92284-5801
Phone (760) 369-4615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
79419CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Garfield Beach CVS LLC PastSince Dec 15, 2019 Accepting new patients
Garfield Beach CVS, L.L.C. PastSince Dec 15, 2019 Accepting new patients
Walgreen Co Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1083274658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15119 BURBANK BLVD APT 9",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914113564",
            "telephone_number": "310-806-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39440 10TH ST W",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935513747",
            "telephone_number": "661-265-7361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "58133 29 Palms Hwy",
            "address_purpose": "LOCATION",
            "city": "Yucca Valley",
            "state": "CA",
            "postal_code": "922845801",
            "country_code": "US",
            "telephone_number": "760-369-4615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMSAMI",
        "first_name": "SEAN",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "79419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; 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.