Provider Demographics
NPI:1801826748
Name:SAMADI, LADAN K (MD)
Entity Type:Individual
Prefix:
First Name:LADAN
Middle Name:K
Last Name:SAMADI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27420 TOURNEY RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5601
Mailing Address - Country:US
Mailing Address - Phone:661-259-9979
Mailing Address - Fax:661-259-1262
Practice Address - Street 1:27420 TOURNEY RD
Practice Address - Street 2:SUITE 220
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5601
Practice Address - Country:US
Practice Address - Phone:661-259-9979
Practice Address - Fax:661-259-1262
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA61255207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A61255OtherCALIFORNIA MEDICAL LICENS
A61255OtherCALIFORNIA MEDICAL LICENS
CAG83520Medicare UPIN
CAA61255Medicare ID - Type Unspecified