Provider Demographics
NPI:1285318097
Name:ALKATEB, SAMER (COF)
Entity type:Individual
Prefix:MR
First Name:SAMER
Middle Name:
Last Name:ALKATEB
Suffix:
Gender:M
Credentials:COF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18271 MCDURMOTT W STE A1
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6754
Mailing Address - Country:US
Mailing Address - Phone:949-228-0884
Mailing Address - Fax:714-848-9363
Practice Address - Street 1:18271 MCDURMOTT W STE F
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6754
Practice Address - Country:US
Practice Address - Phone:949-228-0884
Practice Address - Fax:714-848-9363
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC53641225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter