Provider Demographics
NPI:1578776720
Name:SAMAAN, RODNEY ANTON (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:ANTON
Last Name:SAMAAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5632 VAN NUYS BLVD
Mailing Address - Street 2:SUITE 185
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-4602
Mailing Address - Country:US
Mailing Address - Phone:818-906-4711
Mailing Address - Fax:877-991-4121
Practice Address - Street 1:14901 RINALDI ST
Practice Address - Street 2:STE 335
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1204
Practice Address - Country:US
Practice Address - Phone:818-906-4711
Practice Address - Fax:877-991-4121
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2016-04-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA119309207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
A119309OtherCA LICENSE
A119309OtherCA LICENSE
CACB214209Medicare PIN
CACB215999Medicare PIN
KYP400027701Medicare PIN
CAM400054497Medicare PIN