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General NPI Number Information
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NPI Number | 1275151342
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Entity Type | Organization
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Legal Business Name | CALIFORNIA PEDIATRIC & ADOLESCENT CARE INC
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Dates
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Enumeration Date | 07/06/2020
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Last Update Date | 11/07/2020
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Provider Practice Location Address
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Address Line | 3340 W BALL RD STE A
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City | ANAHEIM
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State | CA
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Zip | 92804-3729
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Country | US
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Telephone | 714-723-0094
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2218
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City | ANAHEIM
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State | CA
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Zip | 92814-0218
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Country | US
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Telephone | 714-931-4173
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SAMEH MOHAMED ELAMIR
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Credential | MD
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Telephone | 714-931-4173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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