Provider Demographics
NPI:1902345036
Name:SAMIR SAIRAM, MD. INC
Entity type:Organization
Organization Name:SAMIR SAIRAM, MD. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:SAIRAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-283-9999
Mailing Address - Street 1:912 COLE ST
Mailing Address - Street 2:#289
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-4316
Mailing Address - Country:US
Mailing Address - Phone:510-283-9999
Mailing Address - Fax:
Practice Address - Street 1:912 COLE ST
Practice Address - Street 2:#289
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-4316
Practice Address - Country:US
Practice Address - Phone:510-283-9999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-22
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97890207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty