Healthcare Provider Details

I. General information

NPI: 1609994482
Provider Name (Legal Business Name): SAMI SROUR, M.D., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 09/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 STOCKDALE HWY SUITE 106
BAKERSFIELD CA
93311-3620
US

IV. Provider business mailing address

9500 STOCKDALE HWY SUITE 106
BAKERSFIELD CA
93311-3620
US

V. Phone/Fax

Practice location:
  • Phone: 661-664-2612
  • Fax:
Mailing address:
  • Phone: 661-664-2612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberG24567
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberG24567
License Number StateCA

VIII. Authorized Official

Name: SAMI SROUR
Title or Position: OWNER
Credential: M.D.
Phone: 661-664-2612