Provider Demographics
NPI:1801142245
Name:HASHEMIAN, SAMANEH SAMMY (OD)
Entity type:Individual
Prefix:
First Name:SAMANEH
Middle Name:SAMMY
Last Name:HASHEMIAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SAMMY
Other - Middle Name:
Other - Last Name:HASHEMIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:4051 RAMPAGE LN
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-3240
Mailing Address - Country:US
Mailing Address - Phone:949-838-5494
Mailing Address - Fax:
Practice Address - Street 1:843 NEWPORT CENTER DR
Practice Address - Street 2:SPACE 84
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-6943
Practice Address - Country:US
Practice Address - Phone:949-718-2040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14433TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist