SAM GHALILI MD INC (NPI# 1891724993) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891724993 |
| Entity Type | Individual |
| Full Name | SAM GHALILI MD INC |
| Credential | M.D. |
| Practice Address |
2101 S San Pedro St Los Angeles CA 90011-1125 |
| Practice Telephone | 2137458766 |
| Practice Fax Number | 2137458704 |
| Mailing Telephone | (213) 745-8766 |
| Mailing Fax Number | 2137458704 |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | A88734 | CA | Allopathic & Osteopathic Physicians |
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
A88734 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | A88734 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 648 E 21st St, Los Angeles, CA 900111146 | 2137497110 | 2137492749 |
| Street Address |
2101 S SAN PEDRO ST |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90011-1125 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881180115 | Curtis Paul Ciesinski | Physician Assistant | 2101 S San Pedro St, Los Angeles, CA 90011-1125 | 2018-07-10 |
| 1720453574 | Sam Ghalili Md Inc | Pediatrics | 2101 S San Pedro St, Los Angeles, CA 90011-1125 | 2015-12-04 |
| 1053672006 | Maziar Mark Ghalili | Internal Medicine | 2101 S San Pedro St, Los Angeles, CA 90011-1125 | 2012-06-06 |
| 1366735813 | Saman Ghalili Md Inc | Emergency Medicine | 2101 S San Pedro St, Los Angeles, CA 90011-1125 | 2011-05-17 |
| 1255493128 | Soleiman Ghalili | Pediatrics | 2101 S San Pedro St, Los Angeles, CA 90011-1125 | 2006-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184223935 | Commercial & Housing Support Aid | Assisted Living Facility | 120 - 122 East 24th Street, Los Angeles, CA 90011 | 2020-10-22 |
| 1295377711 | Joseph D Madrigal | Home Health Aide | 1977 Anzac Ave, Los Angeles, CA 90011 | 2019-10-16 |
| 1538641212 | Brenda Bahena | Community Health Worker | South Central Family Health Center, 4425 S. Central Ave, Los Angeles, CA 90011 | 2018-08-30 |
| 1083101851 | Bronwyn Anne Hazlewood | Student in an Organized Health Care Education/Training Program | 3740 Maple Ave, 1/2 B, Los Angeles, CA 90011 | 2018-04-17 |
| 1164941183 | Kimberly Denise Lister- Gutierrez | Counselor | 303 E 52nd Street, Los Angeles, CA 90011 | 2017-09-11 |
| 1205252533 | Jameese B Smith | Case Manager/Care Coordinator | 271 E. 43rd Street, Los Angeles, CA 90011 | 2014-03-11 |
| 1033533153 | Avalon-carver Community Center | Community/Behavioral Health | 4920 S. Avalon Blvd, Los Angeles, CA 90011 | 2014-02-10 |
| 1245672500 | Kellie D Bougard | Student in an Organized Health Care Education/Training Program | 4920 South Avalon Blvd, Los Angeles, CA 90011 | 2013-07-26 |
| 1578909404 | Ma. Jasmin F Binas | Nurse Practitioner | 2707 S.central Ave., Los Angeles, CA 90011 | 2013-05-19 |
| 1912343344 | California Assisted Pharmacy, Inc | Pharmacy | 646 E 28th St, Ste #1, Los Angeles, CA 90011 | 2013-05-13 |
| Find all providers in zip 90011 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255939674 | Kiira Health Practice Ca PC | General Practice | 123 S Figueroa St Apt 1202, Los Angeles, CA 90012-5490 | 2020-10-16 |
| 1851913917 | St Bishoy Medical Group | General Practice | 8545 Saturn St Apt 103, Los Angeles, CA 90035-3658 | 2020-05-12 |
| 1609403807 | Doctors On The Go Professional Group Corp. | General Practice | 3325 Wilshire Blvd Ste 210, Los Angeles, CA 90010-1718 | 2020-03-26 |
| 1568001584 | Ahdout Health Services, Inc. | General Practice | 2121 Avenue of The Stars # Ll20, Los Angeles, CA 90067-5010 | 2019-12-23 |
| 1104470384 | Chan Family Medical Corp | General Practice | 4070 E. Olympic Blvd, Los Angeles, CA 90023 | 2019-07-26 |
| 1972064004 | Divine Help Medical Group Inc | General Practice | 1711 W Temple St Unit 5613, Los Angeles, CA 90026-5421 | 2019-03-29 |
| 1942767801 | Plaza Health Services Inc. | General Practice | 11111 Santa Monica Blvd Ste 200, Los Angeles, CA 90025-3333 | 2019-02-27 |
| 1124536289 | Edward Meltser | General Practice | 469 N Alfred St, Los Angeles, CA 90048-2504 | 2018-01-11 |
| 1023524980 | St. Johns Urgent Care & Medical Corporation | General Practice | 1138 N Western Ave, Los Angeles, CA 90029-1702 | 2017-12-14 |
| 1992234199 | David Ghods | General Practice | 3631 Crenshaw Blvd Ste 109, Los Angeles, CA 90016-4869 | 2017-06-09 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90011 |
Please comment or provide details below to improve the information on SAM GHALILI MD INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.