| Samakhom Medical Clinic Inc | |
|
300 I St Modesto CA 95351-2826 | |
| (209) 521-2632 | |
| Not Available |
| Full Name | Samakhom Medical Clinic Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 300 I St, Modesto, California |
| Authorized Official Name and Position | Robert J Butler (ADMINISTRATOR) |
| Authorized Official Contact | 2096346432 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Samakhom Medical Clinic Inc Po Box 2128 Merced CA 95344-0128 Ph: (209) 634-6432 | Samakhom Medical Clinic Inc 300 I St Modesto CA 95351-2826 Ph: (209) 521-2632 |
| NPI Number | 1235335431 |
|---|---|
| Provider Enumeration Date | 06/25/2007 |
| Last Update Date | 04/02/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235335431 | NPI | - | NPPES |
| 00G501301 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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