Provider Demographics
NPI:1528176070
Name:MICHAELS, SAMER Y (MD)
Entity type:Individual
Prefix:
First Name:SAMER
Middle Name:Y
Last Name:MICHAELS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1622
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92856
Mailing Address - Country:US
Mailing Address - Phone:866-740-7029
Mailing Address - Fax:
Practice Address - Street 1:3555 CESAR CHAVEZ
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110
Practice Address - Country:US
Practice Address - Phone:415-641-6889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2008-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG69987207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G699870Medicaid
E49774Medicare UPIN
CA00G699870Medicaid
CABB405ZMedicare PIN