Provider Demographics
NPI:1023268869
Name:NYAMU, SAMUEL M (MD)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:M
Last Name:NYAMU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9602
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91346-9602
Mailing Address - Country:US
Mailing Address - Phone:818-837-5559
Mailing Address - Fax:818-792-4793
Practice Address - Street 1:11333 N SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1116
Practice Address - Country:US
Practice Address - Phone:818-869-7248
Practice Address - Fax:818-869-2709
Is Sole Proprietor?:No
Enumeration Date:2008-09-30
Last Update Date:2019-12-18
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Provider Licenses
StateLicense IDTaxonomies
SD8125207R00000X
NETEP 5824207R00000X
CAC165968207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine