| S Corp Inc | |
|
830 E Chapel St Santa Maria CA 93454-4610 | |
| (805) 922-6657 | |
| (805) 436-2364 |
| Full Name | S Corp Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 830 E Chapel St, Santa Maria, California |
| Authorized Official Name and Position | Samer Othman (PRESIDENT/CEO) |
| Authorized Official Contact | 6268007617 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| S Corp Inc Po Box 14632 San Luis Obispo CA 93406-4632 Ph: (626) 800-7617 | S Corp Inc 830 E Chapel St Santa Maria CA 93454-4610 Ph: (805) 922-6657 |
| NPI Number | 1821501560 |
|---|---|
| Provider Enumeration Date | 11/15/2017 |
| Last Update Date | 04/10/2020 |
| Medicare PECOS PAC ID | 6002174802 |
|---|---|
| Medicare Enrollment ID | O20171228001372 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821501560 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A118624 (California) | Primary |
| Provider Name | Samer S. Othman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437476439 PECOS PAC ID: 5092954248 Enrollment ID: I20130618000859 |
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