Provider Demographics
NPI:1780227157
Name:DR SAM HAROUNI INC
Entity Type:Organization
Organization Name:DR SAM HAROUNI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAROUNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-927-6461
Mailing Address - Street 1:350 S BEVERLY DR STE 160B
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4811
Mailing Address - Country:US
Mailing Address - Phone:310-927-6461
Mailing Address - Fax:
Practice Address - Street 1:350 S BEVERLY DR STE 160B
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4811
Practice Address - Country:US
Practice Address - Phone:310-927-6461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty