Individual provider Active NPI

Marciana Mendoza Samson

  • Driver
  • Panorama City, CA
National Provider Identifier
1083991889
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
D5434171 Issued in CA
Practice address
8106 Tilden Ave
Panorama City, CA 91402-5243
Phone
(818) 464-6551
NPI assigned
Nov 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X D5434171 CA Primary

Addresses

Primary practice location

8106 Tilden Ave
Panorama City, CA 91402-5243

Mailing address

8106 Tilden Ave
Panorama City, CA 91402-5243
Phone (818) 464-6551

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

State licenses

LicenseStateTypeSpecialty
D5434171CAMDDriver

NPI Registry JSON

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320710400000",
    "number": "1083991889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8106 TILDEN AVE",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914025243",
            "telephone_number": "818-464-6551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8106 TILDEN AVE",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914025243",
            "telephone_number": "818-464-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMSON",
        "first_name": "MARCIANA",
        "middle_name": "MENDOZA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "CA",
            "license": "D5434171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panorama City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.