Provider Demographics
NPI:1154107332
Name:SAUNDERS, SAMUEL JAMES
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:JAMES
Last Name:SAUNDERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1299 BAMBOO ST
Mailing Address - Street 2:
Mailing Address - City:PLUMAS LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:95961-8714
Mailing Address - Country:US
Mailing Address - Phone:916-910-8306
Mailing Address - Fax:
Practice Address - Street 1:1299 BAMBOO ST
Practice Address - Street 2:
Practice Address - City:PLUMAS LAKE
Practice Address - State:CA
Practice Address - Zip Code:95961-8714
Practice Address - Country:US
Practice Address - Phone:916-910-8306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program