Provider Demographics
NPI:1568475135
Name:HESSAMI, ESMAIL DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:ESMAIL
Middle Name:DAVID
Last Name:HESSAMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 630
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91503
Mailing Address - Country:US
Mailing Address - Phone:818-845-9222
Mailing Address - Fax:818-845-6204
Practice Address - Street 1:500 E OLIVE AVENUE SUITE #740
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91501
Practice Address - Country:US
Practice Address - Phone:818-845-9222
Practice Address - Fax:818-845-6204
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA34841207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A348410Medicaid
A88307Medicare UPIN
CAA34841Medicare ID - Type Unspecified