MEDICARE: DR. SAMY K METYAS MD

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
1	207RR0500X	Rheumatology Physician	A72678	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1831104694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMY K METYAS MD

Provider Business Mailing Address
First Line	:	500 W SAN BERNARDINO RD STE A
Second Line	:
City	:	COVINA
State	:	CA
Zip	:	91722-3797
Country	:	US
Telephone Number	:	626-966-1909
Fax Number	:	626-966-2629

Provider Business Practice Location Address
First Line	:	500 W SAN BERNARDINO RD STE A
Second Line	:
City	:	COVINA
State	:	CA
Zip	:	91722-3797
Country	:	US
Telephone Number	:	626-966-1909
Fax Number	:	626-966-2629

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	10/31/2016

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