Healthcare Provider Details

I. General information

NPI: 1609971357
Provider Name (Legal Business Name): SOMA ANESTHESIA MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 CESAR CHAVEZ
SAN FRANCISCO CA
94110
US

IV. Provider business mailing address

PO BOX 1622
ORANGE CA
92856
US

V. Phone/Fax

Practice location:
  • Phone: 415-641-6889
  • Fax:
Mailing address:
  • Phone: 866-740-7029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SAMER Y MICHAELS
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 856-740-7029