Provider Demographics
NPI:1730316548
Name:SAMIMI, NADIV YEHOSHUA (MD)
Entity Type:Individual
Prefix:DR
First Name:NADIV
Middle Name:YEHOSHUA
Last Name:SAMIMI
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 1:1964 WESTWOOD BLVD
Mailing Address - Street 2:SUITE 435
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4651
Mailing Address - Country:US
Mailing Address - Phone:310-856-9488
Mailing Address - Fax:310-817-6402
Practice Address - Street 1:1964 WESTWOOD BLVD
Practice Address - Street 2:SUITE 435
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4651
Practice Address - Country:US
Practice Address - Phone:310-856-9488
Practice Address - Fax:310-817-6402
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108143207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFW1789WMedicare PIN
CAFI789XMedicare PIN
CAFI789YMedicare PIN