Samakhom Medical Clinic Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

SAMAKHOM MEDICAL CLINIC INC

Practice address

300 I St
Modesto, CA 95351-2826

Phone

(209) 521-2632

NPI assigned

Jun 25, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert J Butler, M.D.

Title

Administrator

Phone

(209) 634-6432

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238630400000",
    "number": "1235335431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2128",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953440128",
            "telephone_number": "209-634-6432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 I ST",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953512826",
            "telephone_number": "209-521-2632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMAKHOM MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2009-04-02",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "209-634-6432",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G501301",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jillian Salvador, RN, PHN
• Marcial Quizon Salvador Jr., MD
• Ann Louise Salvi, BHA
• Anhao Sam, PHARMD
• Abdul Samad
• Ariana Samandari
• Alana Samaniego
• Amber Nicole Samaro
• Kayalvizhi Sambandam, M.D.
• Behrouz Sami Daryani, D.M.D

• Clinic/Center in Modesto, CA
• Providers in Modesto, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.