Organization
SAMAKHOM MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT J BUTLER M.D. (ADMINISTRATOR)
(209) 634-6432
Entity
Organization
Contact information
Practice address
300 I ST, MODESTO, CA 95351-2826
(209) 521-2632
Mailing address
PO BOX 2128, MERCED, CA 95344-0128
(209) 634-6432
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G501301
—
CA
Enumeration date
06/25/2007
Last updated
04/02/2009
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