Provider Demographics
NPI:1275725111
Name:SAMOFF, KARA
Entity Type:Individual
Prefix:MS
First Name:KARA
Middle Name:
Last Name:SAMOFF
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 1:26941 CABOT RD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-7030
Mailing Address - Country:US
Mailing Address - Phone:949-273-6766
Mailing Address - Fax:949-273-6765
Practice Address - Street 1:26941 CABOT RD
Practice Address - Street 2:SUITE 125
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-7030
Practice Address - Country:US
Practice Address - Phone:949-273-6766
Practice Address - Fax:949-273-6765
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 32531225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist