Healthcare Provider Details
I. General information
NPI: 1881862209
Provider Name (Legal Business Name): GEORGE SAMIR ALKHOURI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/19/2008
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
315 MERCY AVE STE 400
MERCED CA
95340-8368
US
IV. Provider business mailing address
3400 DATA DR
RANCHO CORDOVA CA
95670-7956
US
V. Phone/Fax
- Phone: 209-564-3700
- Fax: 209-564-3799
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | A97131 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: