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NPI Code Detail

MEDICARE: SAMANTHA ANNE GAMBLES FARR FNP-C

MEDICARE: SAMANTHA ANNE GAMBLES FARR FNP-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
1163WC0200XCritical Care Medicine Registered Nurse641665CA
2363LF0000XFamily Nurse Practitioner20147CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
120147OTHERCAFNP FURNISHING NUMBER

General Provider Information

NPI Number : 1295971158
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA ANNE GAMBLES FARR FNP-C
Provider Business Mailing Address
First Line : 500 PARNASSUS AVE FL 4
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94143-2203
Country : US
Telephone Number : 415-353-1606
Fax Number :
Provider Business Practice Location Address
First Line : 200 W ARBOR DR # 8896
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-1911
Country : US
Telephone Number : 619-543-7202
Fax Number : 619-543-7200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2008
Last Update Date : 03/07/2023

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