Provider Demographics
NPI:1659968550
Name:SOLEIMANIAN, SAMAHN
Entity Type:Individual
Prefix:DR
First Name:SAMAHN
Middle Name:
Last Name:SOLEIMANIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23140 BIGLER ST
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2707
Mailing Address - Country:US
Mailing Address - Phone:818-456-6639
Mailing Address - Fax:
Practice Address - Street 1:325 N VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-1841
Practice Address - Country:US
Practice Address - Phone:888-658-0801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-25
Last Update Date:2020-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA82384183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist