Provider Demographics
NPI:1093478430
Name:BILLIMORIA, SAM M (MPH, CHES, CPH)
Entity Type:Individual
Prefix:MR
First Name:SAM
Middle Name:M
Last Name:BILLIMORIA
Suffix:
Gender:M
Credentials:MPH, CHES, CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVOH 17247 BIRCHER STREET
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344
Mailing Address - Country:US
Mailing Address - Phone:310-628-4191
Mailing Address - Fax:
Practice Address - Street 1:AVOH 17247 BIRCHER STREET
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344
Practice Address - Country:US
Practice Address - Phone:310-628-4191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator