MEDICARE: SMS MANAGEMENT SERVICES

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1376851527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMS MANAGEMENT SERVICES

Provider Business Mailing Address
First Line	:	2171 S EL CAMINO REAL
Second Line	:	SUITE 210
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6229
Country	:	US
Telephone Number	:	760-967-2720
Fax Number	:

Provider Business Practice Location Address
First Line	:	2171 S EL CAMINO REAL
Second Line	:	SUITE 210
City	:	OCEANSIDE
State	:	CA
Zip	:	92054-6229
Country	:	US
Telephone Number	:	760-967-2720
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SAMVEL KAPOUSHIAN
Credential	:
Telephone Number	:	760-967-2720

Provider Enumeration Date	:	09/22/2010
Last Update Date	:	09/22/2010

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