Romeo Samouh Md Inc | |
811 E 11th St Ste 102 Upland CA 91786-4872 | |
(909) 360-8737 | |
(909) 377-5302 |
Full Name | Romeo Samouh Md Inc |
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Speciality | Family Medicine |
Location | 811 E 11th St Ste 102, Upland, California |
Authorized Official Name and Position | Romeo Samouh (MD/PRESIDENT) |
Authorized Official Contact | 9093608737 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Romeo Samouh Md Inc 811 E 11th St Ste 102 Upland CA 91786-4872 Ph: (909) 360-8737 | Romeo Samouh Md Inc 811 E 11th St Ste 102 Upland CA 91786-4872 Ph: (909) 360-8737 |
NPI Number | 1508304544 |
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Provider Enumeration Date | 02/10/2017 |
Last Update Date | 06/20/2019 |
Medicare PECOS PAC ID | 4981989837 |
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Medicare Enrollment ID | O20170316001366 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508304544 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | A127159 (California) | Primary |
Provider Name | Romeo J Samouh |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1316225436 PECOS PAC ID: 1759688013 Enrollment ID: I20160331000912 |
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Inland Empire Medical Network,inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 585 N Mountain Ave, Suite C, Upland, CA 91786 Phone: 909-981-8599 Fax: 909-981-5441 | |
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