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NPI Code Detail

MEDICARE: SAMUEL MEDRANO M.D.

MEDICARE:   SAMUEL  MEDRANO  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianG68235CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316905334
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL MEDRANO M.D.
Provider Business Mailing Address
First Line : 1990 N CALIFORNIA BLVD
Second Line : SUITE 400
City : WALNUT CREEK
State : CA
Zip : 94596-3742
Country : US
Telephone Number : 925-225-5837
Fax Number :
Provider Business Practice Location Address
First Line : 199 E WEBSTER ST
Second Line :
City : COLUSA
State : CA
Zip : 95932-2954
Country : US
Telephone Number : 530-458-3283
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2006
Last Update Date : 05/12/2016

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Directions to “ SAMUEL MEDRANO M.D.” Practice Location

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