MEDICARE: MS. SAMANTHA ERIN CLEM PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	PA67280	CA
2	363A00000X	Physician Assistant	PA61146565	WA

General Provider Information

NPI Number	:	1063818334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SAMANTHA ERIN CLEM PA-C

Provider Business Mailing Address
First Line	:	2340 CLAY ST FL 6
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-1932
Country	:	US
Telephone Number	:	424-444-7399
Fax Number	:	424-253-0814

Provider Business Practice Location Address
First Line	:	2340 CLAY ST FL 6
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-1932
Country	:	US
Telephone Number	:	424-444-7399
Fax Number	:	424-253-0814

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2014
Last Update Date	:	06/16/2026

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