Organization
SAMARITAN ENDOSCOPY CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BASSAM G SAFFOURI MD (PRESIDENT)
(408) 356-0988
Entity
Organization
Contact information
Practice address
15195 NATIONAL AVENUE, SUITE 204, LOS GATOS, CA 95032-2631
(408) 356-0988
(408) 356-0978
Mailing address
15195 NATIONAL AVENUE, SUITE 204, LOS GATOS, CA 95032-2631
(408) 356-0988
(408) 356-0978
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
550000093
CA
261QE0800X
Endoscopy Clinic/Center
Primary
550000093
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
54220ZZH4328Z
BLUE SHIELD
CA
01
—
550000093
LICENSE
CA
05
—
A51744
—
CA
Enumeration date
09/05/2006
Last updated
03/10/2023
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