Provider Demographics
NPI:1376615401
Name:SAMIA ATEIA MD INC BALDWIN MEDICAL CLINIC
Entity Type:Organization
Organization Name:SAMIA ATEIA MD INC BALDWIN MEDICAL CLINIC
Other - Org Name:BALDWIN MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:NASHAT
Authorized Official - Middle Name:N
Authorized Official - Last Name:ATEIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-960-3753
Mailing Address - Street 1:14135 FRANCISQUITO AVE
Mailing Address - Street 2:SUITE#106
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-6107
Mailing Address - Country:US
Mailing Address - Phone:626-960-3753
Mailing Address - Fax:626-962-9866
Practice Address - Street 1:14135 FRANCISQUITO AVE
Practice Address - Street 2:SUITE#106
Practice Address - City:BALDWIN PARK
Practice Address - State:CA
Practice Address - Zip Code:91706-6107
Practice Address - Country:US
Practice Address - Phone:626-960-3753
Practice Address - Fax:626-962-9866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207V00000X207V00000X
CA208000000X208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty