Organization
ST MEDICAL INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMER SANNOUFI MD (PRESIDENT)
(480) 626-3416
Entity
Organization
Contact information
Practice address
4137 MAINE AVE, BALDWIN PARK, CA 91706-3309
(480) 626-3416
Mailing address
6900 BROCKTON AVE STE 200, RIVERSIDE, CA 92506-3818
(951) 682-6263
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/27/2019
Last updated
12/27/2019
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