Provider Demographics
NPI:1609994482
Name:SAMI SROUR, M.D., INC
Entity type:Organization
Organization Name:SAMI SROUR, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:SROUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-664-2612
Mailing Address - Street 1:9500 STOCKDALE HWY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-3620
Mailing Address - Country:US
Mailing Address - Phone:661-664-2612
Mailing Address - Fax:
Practice Address - Street 1:9500 STOCKDALE HWY
Practice Address - Street 2:SUITE 106
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-3620
Practice Address - Country:US
Practice Address - Phone:661-664-2612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG24567207X00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA756202891OtherMEDICARE RAILROAD
CA0778520001Medicare NSC
CA756202891OtherMEDICARE RAILROAD
CAA42301Medicare UPIN