SAM GHALILI MD INC M.D. NPI 1891724993

NPI Information

NPI: 1891724993
Provider Name: SAM GHALILI MD INC, M.D.
Classification: General Practice - 208D00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2101 S SAN PEDRO ST
LOS ANGELES, CA
ZIP 90011
Phone: (213) 745-8766
Get Directions

Sam Ghalili Md Inc, M.D. is a general practice in Los Angeles, CA with 21 years of experience. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee Sam Ghalili Md Inc, M.D. NPI is 1891724993. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TUFTS UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2003

The provider's business location address is:

2101 S SAN PEDRO ST
LOS ANGELES, CA
ZIP 90011-125
Phone: (213) 745-8766
Fax: (213) 745-8704

The NPI 1891724993 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/1/2006 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QU0200X	Clinic/Center	Urgent Care	A88734	CALIFORNIA	No
2	208D00000X	General Practice		A88734	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	A88734	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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