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Organization
S CORP INC
Active
Organization
S CORP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMER OTHMAN MD (PRESIDENT/CEO)
(626) 800-7617
Entity
Organization
Contact information
Practice address
830 E CHAPEL ST, SANTA MARIA, CA 93454-4610
(805) 922-6657
(805) 436-2364
Mailing address
PO BOX 14632, SAN LUIS OBISPO, CA 93406-4632
(626) 800-7617
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A118624
CA
Other
Enumeration date
11/15/2017
Last updated
04/10/2020
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