Provider Demographics
NPI:1336514546
Name:SAMY SHAROBEEM, MD INC
Entity Type:Organization
Organization Name:SAMY SHAROBEEM, MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SAMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAROBEEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-203-0222
Mailing Address - Street 1:8549 WILSHIRE BLVD STE 1414
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3104
Mailing Address - Country:US
Mailing Address - Phone:310-203-0222
Mailing Address - Fax:310-652-4053
Practice Address - Street 1:150 N ROBERTSON BLVD STE 150
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2171
Practice Address - Country:US
Practice Address - Phone:310-203-0222
Practice Address - Fax:310-652-4053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-14
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
BU770ZMedicare PIN