Sam Ghalili MD Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

SAM GHALILI MD INC

Practice address

2101 S San Pedro St
Los Angeles, CA 90011-1125

Phone

(213) 845-8766

Fax

(213) 745-8704

NPI assigned

Dec 4, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Sam Ghalili, M.D.

Title

Owner

Phone

(213) 749-7110

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Sam Ghalili MD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Saman Ghalili MD Inc

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1366735813
  NPD tax ID

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Saman Ghalili, M.D.

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1891724993
  Medicare reassignment NPD
• Steven Ghalili, MD

  • Family Medicine Physician
  • Los Angeles, CA
  • NPI 1669546453
  NPD
• Deborah Borah, PA-C

  • Physician Assistant
  • Los Angeles, CA
  • NPI 1871775627
  NPD (past)
• Curtis Paul Ciesinski, PA

  • Physician Assistant
  • San Francisco, CA
  • NPI 1881180115
  NPD (past)
• Maziar Mark Ghalili, D.O.

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1053672006
  NPD (past)
• Laura P. Lamas-Guzman, PA-C

  • Physician Assistant
  • Los Angeles, CA
  • NPI 1538890421
  NPD (past)
• Justin Jacob Ramirez, P.A.

  • Physician Assistant
  • Mission Hills, CA
  • NPI 1942861182
  NPD (past)

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

{
    "created_epoch": "1449187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474416000000",
    "number": "1720453574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 S SAN PEDRO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900111125",
            "telephone_number": "213-845-8766",
            "fax_number": "213-745-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 S SAN PEDRO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900111125",
            "telephone_number": "213-845-8766",
            "fax_number": "213-745-8704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM GHALILI MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-04",
        "last_updated": "2016-09-21",
        "status": "A",
        "authorized_official_last_name": "GHALILI",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-749-7110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A88734",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A088734",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Garrett Salzman, MD
• Mark B. Salzman, MD
• Sam a. Lavi DMD Inc
• Sam Bakshian MD a Medical Corporation
• Sam Breen, Licensed Marriage and Family Therapist, Inc.
• Amy Evette Sam Kwarteng, MD
• Sam Sanandaji, DPM
• Sam Vaziri Vance Inc. (Sama)
• Andre-Philippe Sam, MD
• Angela Sam, MD

• General Practice Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.