Samuel S. Im, MD, Inc.

Primary specialty

Gynecologic Oncology PhysicianTaxonomy code 207VX0201X

License

A71341 Issued in CA

Legal business name

SAMUEL S. IM, MD, INC.

Practice address

12462 Putnam St
Suite 303
Whittier, CA 90602-1048

Phone

(562) 900-1012

Fax

(562) 789-4440

NPI assigned

Jun 3, 2008

Last updated

Oct 12, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Samuel S Im, M.DNPI 1790839496

Title

Owner

Phone

(562) 900-1012

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Samuel Im, M.D.

  • Gynecologic Oncology Physician
  • Whittier, CA
  • NPI 1790839496
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318377600000",
    "number": "1235398439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4316",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907034316",
            "telephone_number": "562-900-1012",
            "fax_number": "562-789-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12462 PUTNAM ST",
            "address_2": "SUITE 303",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906021048",
            "telephone_number": "562-900-1012",
            "fax_number": "562-789-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL S. IM, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "last_updated": "2011-10-12",
        "status": "A",
        "authorized_official_last_name": "IM",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-900-1012",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "CA",
            "license": "A71341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gynecologic Oncology Physician in Whittier, CA
• Providers in Whittier, CA by specialty
• Gynecologic Oncology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.