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General NPI Number Information
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NPI Number | 1811188428
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Entity Type | Organization
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Legal Business Name | JOHN W SAMPLES, MD,, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 35400 BOB HOPE DR SUITE A 201
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-1772
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Country | US
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Telephone | 909-496-7128
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Fax | 951-769-7481
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Provider Business Mailing Address
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Address Line | 44489 TOWN CENTER WAY # D405
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City | PALM DESERT
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State | CA
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Zip | 92260-2723
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Country | US
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Telephone | 909-496-7128
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Fax | 951-769-7481
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN W SAMPLES
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Credential | M.D.
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Telephone | 909-496-7128
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A66241
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License Number State | CA
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