Provider Demographics
NPI:1881982486
Name:SAMANI, PARGOL
Entity type:Individual
Prefix:
First Name:PARGOL
Middle Name:
Last Name:SAMANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3927 WARING RD STE C
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-4458
Mailing Address - Country:US
Mailing Address - Phone:619-703-7220
Mailing Address - Fax:
Practice Address - Street 1:3927 WARING RD STE C
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4458
Practice Address - Country:US
Practice Address - Phone:619-703-7220
Practice Address - Fax:619-703-7221
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-16
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA141390207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease