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General NPI Number Information
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NPI Number | 1366964678
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Entity Type | Individual
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Provider Name | SAMEET MOOR DO
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Gender | Male
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Dates
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Enumeration Date | 07/10/2017
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 16888 BASELINE AVE
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City | FONTANA
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State | CA
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Zip | 92336-2083
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Country | US
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Telephone | 855-422-8029
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Fax |
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Provider Business Mailing Address
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Address Line | 903 W MARTIN ST # MS 49-2
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City | SAN ANTONIO
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State | TX
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Zip | 78207-0903
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Country | US
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Telephone | 210-358-0572
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Fax | 210-358-5940
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 23084
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | V2174
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R10992
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License Number State | IA
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R10992
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License Number State | TX
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