Organization Name: | SAN ANTONIO MEDICAL CENTER INC. |
NPI Number: | 1972825305 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | IHSAN NAJIB SHAMAAN (MEDICAL DIRECTOR/OWNER) |
Mailing Address: | 610 W. 17th Street Santa Ana |
State: | CA US |
Postal Code: | 92706 |
Phone Number: | 7145414090 |
Fax Number: | 7145418815 |
NPI Enumeration Date: | 02/26/2010 |
NPI Last Update Date: | 02/26/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | A36951 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |