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General NPI Number Information
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NPI Number | 1396720710
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Entity Type | Individual
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Provider Name | SAMER ELHAKIM MD
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Gender | Male
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Dates
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Enumeration Date | 12/08/2005
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Last Update Date | 06/15/2022
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Provider Practice Location Address
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Address Line | 459 W LINE ST STE C
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City | BISHOP
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State | CA
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Zip | 93514-3333
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Country | US
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Telephone | 760-784-7020
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Fax |
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Provider Business Mailing Address
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Address Line | 18260 NE 19TH AVE SUITE 201
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-1632
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Country | US
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Telephone | 305-956-9062
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Fax |
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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 | ME79405
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A64024
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License Number State | CA
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