Provider Demographics
NPI:1093321606
Name:SAMEL, BELLA ESTHER
Entity Type:Individual
Prefix:
First Name:BELLA
Middle Name:ESTHER
Last Name:SAMEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9121 ATLANTA AVE STE 222
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-6309
Mailing Address - Country:US
Mailing Address - Phone:310-780-8380
Mailing Address - Fax:
Practice Address - Street 1:9121 ATLANTA AVE STE 222
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92646-6309
Practice Address - Country:US
Practice Address - Phone:310-780-8380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5107225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist