Provider Demographics
NPI:1518129980
Name:CHAI, SAMANTHA (MD)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:CHAI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4220 W 3RD ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020-3450
Mailing Address - Country:US
Mailing Address - Phone:213-380-8800
Mailing Address - Fax:213-381-7474
Practice Address - Street 1:4220 W 3RD ST
Practice Address - Street 2:SUITE 206
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90020-3450
Practice Address - Country:US
Practice Address - Phone:213-380-8800
Practice Address - Fax:213-381-7474
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35091136207W00000X
FLME108130207W00000X
TXN3545207W00000X
CAA118261207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology