Provider Demographics
NPI:1487018263
Name:CARLEY, SAMA KASSIRA (MD)
Entity Type:Individual
Prefix:
First Name:SAMA
Middle Name:KASSIRA
Last Name:CARLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SAMA
Other - Middle Name:
Other - Last Name:KASSIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8701 CUYAMACA ST
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-4253
Mailing Address - Country:US
Mailing Address - Phone:619-568-8222
Mailing Address - Fax:
Practice Address - Street 1:8701 CUYAMACA ST
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-4253
Practice Address - Country:US
Practice Address - Phone:619-568-8222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-07
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN67075207ND0101X
CAA151286207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery