Individual provider Active NPI

Patricia C Samuels, MD

  • Infectious Disease Physician
  • Los Angeles, CA
National Provider Identifier
1336210459
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
G54805 Issued in CA
Practice address
6230 Wilshire Blvd
Ste 184
Los Angeles, CA 90048-5104
Phone
(213) 999-7714
NPI assigned
Nov 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X G54805 CA Primary

Addresses

Primary practice location

6230 Wilshire Blvd
Ste 184
Los Angeles, CA 90048-5104

Mailing address

6230 Wilshire Blvd
Ste 184
Los Angeles, CA 90048-5104
Phone (213) 999-7714

Other identifiers 1

IdentifierTypeStateIssuer
00G548050MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090414000566 CA Practitioner - Infectious Disease 9133276959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
JS Weill Medical College, Cornell University, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10841 White Oak Ave
Rancho Cucamonga, CA 91730-3811
Phone (909) 527-8921

2224 Medical Ctr Dr
Perris, CA 92571-2638
Phone (951) 436-3535

800 S Main St
Corona, CA 92882-3420
Phone (951) 736-6200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Patricia C Samuels MD Inc Infectious Disease CurrentSince Jan 4, 2008 Accepting new patients

Locations

6230 Wilshire Blvd
#184
Los Angeles, CA 90048
Phone (951) 505-2591

6230 Wilshire Blvd
Ste 184
Los Angeles, CA 90048
Phone (213) 999-7714

25405 Hancock Ave
Ste 105
Murrieta, CA 92562
Phone (951) 677-1323

10841 White Oak Ave
Rch Cucamonga, CA 91730
Phone (626) 914-1514

1940 El Cajon Blvd
San Diego, CA 92104
Phone (619) 543-4500

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336210459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6230 WILSHIRE BLVD",
            "address_2": "STE 184",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485104",
            "telephone_number": "213-999-7714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6230 WILSHIRE BLVD",
            "address_2": "STE 184",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485104",
            "telephone_number": "213-999-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "PATRICIA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "G54805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G548050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.