Provider Demographics
NPI:1780621268
Name:ZAMZAM, SAMI S (MD)
Entity type:Individual
Prefix:DR
First Name:SAMI
Middle Name:S
Last Name:ZAMZAM
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 1:2970 MELA VIA CT NE
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-8169
Mailing Address - Country:US
Mailing Address - Phone:775-287-7174
Mailing Address - Fax:
Practice Address - Street 1:898 N PACIFIC COAST HWY STE 600
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-2747
Practice Address - Country:US
Practice Address - Phone:310-698-5254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301072778207L00000X
NV10242207L00000X
CAC196713207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2016946Medicaid
MIM71590133Medicare PIN
NVH71189Medicare UPIN
NV36813Medicare PIN