Provider Demographics
NPI:1902007594
Name:SAMI B HAMAMJI MD INC
Entity Type:Organization
Organization Name:SAMI B HAMAMJI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMI
Authorized Official - Middle Name:B
Authorized Official - Last Name:HAMAMJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-541-5959
Mailing Address - Street 1:1010 W LA VETA AVE STE 775
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4306
Mailing Address - Country:US
Mailing Address - Phone:714-541-5959
Mailing Address - Fax:714-835-9550
Practice Address - Street 1:1010 W LA VETA AVE STE 775
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4306
Practice Address - Country:US
Practice Address - Phone:714-541-5959
Practice Address - Fax:714-835-9550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA049367174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A493670Medicaid
CAA49367Medicare ID - Type Unspecified
CAF13108Medicare UPIN