Mr Sidary Sam, MSW is a
Social Worker - Clinical based in Long Beach, California. Mr Sidary Sam is licensed to practice in California (license number LCSW94013) and his current practice location is
4510 E Pacific Coast Hwy Ste 600, Long Beach, California. He can be reached at his office (for appointments etc.) via phone at
(562) 346-1100.
NPI number for Mr Sidary Sam is 1962557900 and his current mailing address is 4510 E Pacific Coast Hwy Ste 600, Long Beach, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1962557900.
Healthcare Provider's Profile
| Full Name | Mr Sidary Sam |
|---|
| Gender | Male |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 4510 E Pacific Coast Hwy Ste 600, Long Beach, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1962557900
- Provider Enumeration Date: 01/23/2007
- Last Update Date: 03/08/2021
Medical Identifiers
Medical identifiers for Mr Sidary Sam such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962557900 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | ASW 22278 (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | LCSW94013 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Sidary Sam is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Sidary Sam, MSW
4510 E Pacific Coast Hwy Ste 600,
Long Beach, CA 90804-6914
Ph: (562) 346-1100 | Mr Sidary Sam, MSW
4510 E Pacific Coast Hwy Ste 600,
Long Beach, CA 90804-6914
Ph: (562) 346-1100 |
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