Samih Wadieh Boutros, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A51600 Issued in CA

Practice address

405 Davis CT
#1703
San Francisco, CA 94111-2449

Phone

(415) 398-0115

Fax

(415) 398-0115

NPI assigned

Feb 21, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811022064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 DAVIS CT",
            "address_2": "#1703",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941112437",
            "telephone_number": "415-398-0115",
            "fax_number": "415-398-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 DAVIS CT",
            "address_2": "#1703",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941112449",
            "telephone_number": "415-398-0115",
            "fax_number": "415-398-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTROS",
        "first_name": "SAMIH",
        "middle_name": "WADIEH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A51600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea L Bourne, AU.D.
• Megan Rose Bourne, MSW
• Sarah Bourne
• Homer A. Boushey, MD
• Esther Boutros
• Liliana Bouvet
• Amy Bouvin, LCSW
• Riley Bove, M.D.
• David Bowden
• Denise Mailloux Bowden, M.S., L.AC.

• Psychiatry Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.