Provider Demographics
NPI:1518318104
Name:ALBHAISI, SOMAYA A M (MBBCH, MPH)
Entity type:Individual
Prefix:
First Name:SOMAYA
Middle Name:A M
Last Name:ALBHAISI
Suffix:
Gender:F
Credentials:MBBCH, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1983 MARENGO ST RM B4H100
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1370
Mailing Address - Country:US
Mailing Address - Phone:323-409-7995
Mailing Address - Fax:323-441-8352
Practice Address - Street 1:1983 MARENGO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1370
Practice Address - Country:US
Practice Address - Phone:323-409-7995
Practice Address - Fax:323-441-8352
Is Sole Proprietor?:No
Enumeration Date:2016-06-25
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC195570207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology