Provider Demographics
NPI:1447561170
Name:SAMAN, MARION
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:
Last Name:SAMAN
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 1:819 UNIVERSITY AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3204
Mailing Address - Country:US
Mailing Address - Phone:718-666-5883
Mailing Address - Fax:
Practice Address - Street 1:1512 ARIZONA ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85001-2020
Practice Address - Country:US
Practice Address - Phone:516-285-2565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-28
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67392183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist