Provider Demographics
NPI:1598737025
Name:SAMSONOV, MARIA E (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:E
Last Name:SAMSONOV
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 CALIFORNIA ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4586
Mailing Address - Country:US
Mailing Address - Phone:415-386-5388
Mailing Address - Fax:415-386-8406
Practice Address - Street 1:1700 CALIFORNIA ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-4586
Practice Address - Country:US
Practice Address - Phone:415-386-8406
Practice Address - Fax:415-386-8406
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91227207RG0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A91227Medicaid
CAI31563Medicare UPIN
CA00A912270Medicare ID - Type UnspecifiedMEDICARE NUMBER