Provider Demographics
NPI:1952579310
Name:SAMUEL KREMEN, M.D. INC.
Entity Type:Organization
Organization Name:SAMUEL KREMEN, M.D. INC.
Other - Org Name:KREMEN & PESSELNICK, M.D.'S
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KREMEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-676-4124
Mailing Address - Street 1:7300 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1902
Mailing Address - Country:US
Mailing Address - Phone:818-676-4124
Mailing Address - Fax:
Practice Address - Street 1:7300 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1902
Practice Address - Country:US
Practice Address - Phone:818-676-4124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA15905207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA15905OtherCALIFORNIA LICENSE
CAHW10866Medicare PIN
CAA15905OtherCALIFORNIA LICENSE