Doctor Name: | SAMER KANNO |
NPI Number: | 1013271147 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 4301100339 |
Business Practice Address: | 354 Santa Fe Dr Encinitas, CA - 920245142 |
Business Phone Number: | 7602302251 |
Business Fax Number: | |
Mailing Address: | Po Box 231189, ENCINITAS |
State: | CA |
Postal Code: | 920231189 |
Phone Number: | 7602302251 |
Fax Number: | |
NPI Enumeration Date: | 07/03/2012 |
NPI Last Update Date: | 05/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 4301100339 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |