SAMIR B. DAMANI MD INC (NPI# 1922371228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922371228 |
| Entity Type | Organization |
| Organization Name | SAMIR B. DAMANI MD INC |
| Other Organization Name | MD REVOLUTION |
| Practice Address |
9850 Genesee Ave Suite 730 La Jolla CA 92037 |
| Practice Telephone | 8588475064 |
| Practice Fax Number | 8584334099 |
| Mailing Telephone | 8588475064 |
| Mailing Fax Number | 8584334099 |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2013-06-17 |
| Authorized Official Name | DR. SAMIR B DAMANI (PHYSICIAN) |
| Authorized Official Telephone | 8588475064 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | MD REVOLUTION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
Allopathic & Osteopathic Physicians | ||
| N | 207SG0201X |
Medical Genetics Specialization: Clinical Genetics (M.D.) |
A88989 | CA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | A88989 | CA | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
A88989 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A889890 | 05 |
| Other Name | Type Code |
|---|---|
| MD Revolution | Doing Business As Name - Organization |
| Street Address |
9850 GENESEE AVE SUITE 730 |
| City | LA JOLLA |
| State | CA |
| Zip Code | 92037 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598760589 | Frank Edward Mayer | Internal Medicine | 9850 Genesee Ave, Ste 930, La Jolla, CA 92037-1229 | 2005-06-16 |
| 1649717737 | La Jolla Anesthesia Associates Lp | Nurse Anesthetist, Certified Registered | 9850 Genesee Ave, Suite 980, La Jolla, CA 92037-1224 | 2017-01-26 |
| 1083151674 | Stephanie Klein | Physician Assistant | 9850 Genesee Ave, Ste 320, La Jolla, CA 92037-1208 | 2017-01-20 |
| 1346785250 | Lee Marie Atwood | Nurse Practitioner | 9850 Genesee Ave, Suite 400, La Jolla, CA 92037-1224 | 2017-01-01 |
| 1447795661 | Kirsten Goshen | Nurse Practitioner | 9850 Genesee Ave, Suite 570, La Jolla, CA 92037-1224 | 2016-12-24 |
| 1194279901 | Ellen Ashman | Nurse Practitioner | 9850 Genesee Ave, La Jolla, CA 92037-1224 | 2016-08-09 |
| 1164875175 | Miranda Mulholland | Nurse Practitioner | 9850 Genesee Ave, Suite 560, La Jolla, CA 92037-1224 | 2016-07-14 |
| 1578938023 | Schoemann Medical Corporation | Surgery | 9850 Genesee Ave, Suite 500, La Jolla, CA 92037-1224 | 2015-12-09 |
| 1679946040 | Lauren E Campagna | Physician Assistant | 9850 Genesee Ave, Suite 320, La Jolla, CA 92037-1224 | 2015-11-07 |
| 1750751269 | Charles Mears | Specialist/Technologist, Other | 9850 Genesee Ave, Suite210, La Jolla, CA 92037-1224 | 2015-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982221768 | Equip Health Medical, PC | Clinic/Center | 2674 Costebelle Drive, Unit A, La Jolla, CA 92037 | 2020-06-29 |
| 1134745474 | Brenda Kay Wiederhold | Psychologist | Virtual Reality Medical Center, 9834 Genesee Avenue, Suite 427, La Jolla, CA 92037 | 2020-06-23 |
| 1316581598 | Kathleen M Blechertas | Physical Therapist | 9888 Genesee, Lj19, La Jolla, CA 92037 | 2019-10-31 |
| 1316592876 | Kevin Yanyan Li | Student in an Organized Health Care Education/Training Program | 9300 Campus Point Drive, Mc7400, La Jolla, CA 92037 | 2019-08-01 |
| 1407400542 | Juan J Salmeron | Dentist | Callejin Internacional 351 L2, Los Algodones, BAJA CALIFORNIA 92037 | 2019-07-26 |
| 1609428598 | Nicole Whitney Mark | Physician Assistant | 8103 Caminito Sonoma, La Jolla, CA 92037 | 2019-07-11 |
| 1700357936 | Cecelia Rose Greene/pendzich | Mastectomy Fitter | 7760 Fay Ave, Suite M., La Jolla, CA 92037 | 2018-12-16 |
| 1740765890 | Jeenal Ankit Gordhandas | Student in an Organized Health Care Education/Training Program | East Campus Office Building, Medical Center Dr, La Jolla, CA 92037 | 2018-09-25 |
| 1306325220 | Lisa Beth Perlov Marks | Marriage & Family Therapist | 7734 Hershel Avenue, Suite O, La Jolla, CA 92037 | 2018-08-10 |
| 1023596731 | Uc San Diego, Pathology Dept | Pathology | East Campus Office Building, Medical Center Dr, San Diego, CA 92037 | 2018-08-03 |
| Find all providers in zip 92037 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205253259 | Marc Henis | Internal Medicine | 1734 Caminito Ardiente, La Jolla, CA 92037-7134 | 2014-03-26 |
| 1093027799 | Bradley Clark Nelson | Internal Medicine | 9500 Gilman Drive, Mail Code 7411, University of California San Diego Health System, La Jolla, CA 92037 | 2010-07-09 |
| 1699925545 | George Mendenhall | Internal Medicine | 9850 Genesee Ave Ste 940, La Jolla, CA 92037 | 2008-09-29 |
| 1962675462 | James Patrick Gray | Internal Medicine | 10820 N Torrey Pines Rd # Fc3, La Jolla, CA 92037-1036 | 2008-04-07 |
| 1780883082 | John Nader Bahadorani | Internal Medicine | 9434 Medical Center Dr, La Jolla, CA 92037-1337 | 2007-07-16 |
| 1124164991 | Thomas John Mcgarry | Internal Medicine | 9444 Medical Center Dr, Mc 7411, La Jolla, CA 92037-1337 | 2007-01-29 |
| 1417026436 | Marcus Lejon Williams | Internal Medicine | 10666 N Torrey Pines Road, La Jolla, CA 92037-1027 | 2006-11-06 |
| 1437239530 | Filip Fattohi | Internal Medicine | 9850 Genesee Ave Ste 770, La Jolla, CA 92037-1232 | 2006-10-16 |
| 1679584551 | Dennis L. Costello | Internal Medicine | 9850 Genesee Ave Ste 780, La Jolla, CA 92037-1232 | 2006-08-10 |
| 1336181858 | Ernest E Pund Jr. | Internal Medicine | 1796 La Jolla Rancho Rd, La Jolla, CA 92037-7847 | 2006-06-11 |
| Find all providers in LA JOLLA | ||||
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| 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.