Provider Demographics
NPI:1780803080
Name:SAMIMI ORTHOPEDIC GROUP, INC.
Entity type:Organization
Organization Name:SAMIMI ORTHOPEDIC GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED ORTHRO SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:HESHMATOLLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHRIAREE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-338-7391
Mailing Address - Street 1:PO BOX 1628
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91793-1628
Mailing Address - Country:US
Mailing Address - Phone:626-338-7391
Mailing Address - Fax:626-814-8308
Practice Address - Street 1:741 S ORANGE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91790-2662
Practice Address - Country:US
Practice Address - Phone:626-338-7391
Practice Address - Fax:626-814-8308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA043899207X00000X, 207XS0114X, 207XX0005X
CAA36076207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Single Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA36076OtherH SHAHRIAREE, MD
CAA043899OtherS SAMIMI, MD
CAA043899OtherS SAMIMI, MD
CAA36076OtherH SHAHRIAREE, MD