Khorsandi, Sam S
Khorsandi, Sam S is an sole proprietor health care provider with primary practice located at 16542 Ventura Blvd Suite 506, Encino CA 91436-2005. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Khorsandi, Sam S can be contacted via phone (818) 981-4867.Contact Information
Primary practice address
16542 Ventura Blvd Suite 506
Encino CA 91436-2005
Phone: (818) 981-4867
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Periodontics | 1223P0300X | 36257 | California |
Profile Details
| NPI number | 1629109996 |
|---|---|
| LBN Legal business name | Khorsandi, Sam S |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 8th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629109996 | NPPES |
| California | MEDICAID | B3625701 |
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