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Organization
SIERRA MADRE COMMUNITY MEDICAL GROUP, INC
Active
Organization
SIERRA MADRE COMMUNITY MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANI SAMI MD (PRESIDENT/ PHYSICIAN)
(626) 921-1808
Entity
Organization
Contact information
Practice address
147 W SIERRA MADRE BLVD, SIERRA MADRE, CA 91024-2492
(626) 355-3443
(626) 355-7843
Mailing address
147 W SIERRA MADRE BLVD, SIERRA MADRE, CA 91024-2492
(626) 355-3443
(626) 355-7843
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0087460
—
CA
01
—
ZZZ606482
BLUE SHIELD
CA
Enumeration date
01/23/2007
Last updated
02/17/2022
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