Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mark Shawn Samuel

Individual provider Family Nurse Practitioner · NPI 1184402083

Mark Shawn Samuel is a Family Nurse Practitioner in Los Angeles, California. Licensed in California and Washington. Registered with an NPI since 2023.

Licensed in
CA, WA
In the registry since
2023
Specialties on file
2

Practice location Address checks out

11301 Wilshire Blvd
Los Angeles, CA 90073-1003
Phone: (661) 992-6212
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 95028358 (CA)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence AP61477587 (WA)

Record details

NPI number1184402083
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 20, 2023
Last updated in NPPESAugust 8, 2026
Certification dateAugust 8, 2026

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