Michel Sam, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A109856 Issued in CA

Practice address

13601 San Pablo Ave
San Pablo, CA 94806-3818

Phone

(510) 231-9593

Fax

(510) 231-9401

NPI assigned

Nov 23, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1679801161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13601 SAN PABLO AVE",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063818",
            "telephone_number": "510-231-9593",
            "fax_number": "510-231-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13601 SAN PABLO AVE",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063818",
            "telephone_number": "510-231-9593",
            "fax_number": "510-231-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAM",
        "first_name": "MICHEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-23",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A109856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Russell Greenwood
• Michelle Russell
• Daniella K Rutashongerwa
• Erica Saavedra Vazquez
• Neil Steven Sachs, MD, MPH
• Sandra Maltez Sampaio, MSW
• Harkaran Singh Samra, RN
• Jovitha Angeline Samy, FNP-C
• San Pablo Anesthesiology Medical Corporation
• San Pablo Healthcare & Wellness Center LLC

• Family Medicine Physician in San Pablo, CA
• Providers in San Pablo, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.