Provider Demographics
NPI:1245730332
Name:DANESH, SAMI (PHARMD)
Entity type:Individual
Prefix:
First Name:SAMI
Middle Name:
Last Name:DANESH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:MOHAMMAD
Other - Middle Name:
Other - Last Name:SAMIEI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4840 SHAWLINE ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1400
Mailing Address - Country:US
Mailing Address - Phone:858-268-7840
Mailing Address - Fax:
Practice Address - Street 1:4840 SHAWLINE ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1400
Practice Address - Country:US
Practice Address - Phone:858-268-7840
Practice Address - Fax:858-268-7876
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69851183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist