Healthcare Provider Details

I. General information

NPI: 1194662114
Provider Name (Legal Business Name): SAMIA GHAFFAR MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 N MAGNOLIA AVE STE 100
CLOVIS CA
93611-9205
US

IV. Provider business mailing address

PO BOX 25042
FRESNO CA
93729-5042
US

V. Phone/Fax

Practice location:
  • Phone: 559-246-5040
  • Fax: 559-892-4550
Mailing address:
  • Phone: 559-892-4500
  • Fax: 559-892-4550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: BETTE STANFORD
Title or Position: ADMINISTRATOR
Credential:
Phone: 559-892-4500