Sally Sample MD Inc

Primary specialty

ContractorTaxonomy code 171W00000X

Legal business name

SALLY SAMPLE MD INC

Practice address

658 Bianco CT
Davis, CA 95616-0608

Phone

(530) 220-0176

NPI assigned

Feb 24, 2015

Last updated

Feb 24, 2015By 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

Sally Sample, M.D.

Title

Medical Doctor

Phone

(530) 220-0176

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424736000000",
    "number": "1881086072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 BIANCO CT",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956160608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 BIANCO CT",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956160608",
            "telephone_number": "530-220-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALLY SAMPLE MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-24",
        "last_updated": "2015-02-24",
        "status": "A",
        "authorized_official_last_name": "SAMPLE",
        "authorized_official_first_name": "SALLY",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "530-220-0176",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi Sakai
• Aisha Oyinkansola Salami
• Maha Saleh
• Eric Sales, MD
• Rumneek Sall
• Siona Samanta
• Samer S. Alassaad DDS, Inc
• Rasa B Sammy, L.AC.
• Jaiya Kaur Samra
• Tamara Natalia Sanchez-Barker, PSY.D.

• Contractor in Davis, CA
• Providers in Davis, CA by specialty
• Contractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; 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.