Provider Demographics
NPI:1619129426
Name:KALIOUNDJI, SAM JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:SAM
Middle Name:JOSEPH
Last Name:KALIOUNDJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18406 ROSCOE BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-4107
Mailing Address - Country:US
Mailing Address - Phone:818-477-2337
Mailing Address - Fax:
Practice Address - Street 1:18406 ROSCOE BLVD
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91325-4107
Practice Address - Country:US
Practice Address - Phone:818-477-2337
Practice Address - Fax:818-936-0844
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-13
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA105168207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease