MEDICARE: SAINT PETER MEDICAL CENTER

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	225100000X	Physical Therapist
2	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1295262392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINT PETER MEDICAL CENTER

Provider Business Mailing Address
First Line	:	677-93 S. MAGNOLIA AVENUE
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-5224
Country	:	US
Telephone Number	:	619-332-8484
Fax Number	:	619-332-8488

Provider Business Practice Location Address
First Line	:	677-93 S. MAGNOLIA AVENUE
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-5224
Country	:	US
Telephone Number	:	619-332-8484
Fax Number	:	619-332-8488

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LABEED SAMI NOURI
Credential	:	MD
Telephone Number	:	619-332-8484

Provider Enumeration Date	:	05/19/2017
Last Update Date	:	11/19/2025

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Directions to “SAINT PETER MEDICAL CENTER ” Practice Location

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