Provider Demographics
NPI:1558973669
Name:SAMER SHUAIB MD INC
Entity Type:Organization
Organization Name:SAMER SHUAIB MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMER
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUAIB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-997-1108
Mailing Address - Street 1:7439 LA PALMA AVE
Mailing Address - Street 2:PMB 120
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90620-2655
Mailing Address - Country:US
Mailing Address - Phone:714-522-2001
Mailing Address - Fax:714-522-7503
Practice Address - Street 1:2617 E CHAPMAN AVE STE 109
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-3245
Practice Address - Country:US
Practice Address - Phone:714-882-2800
Practice Address - Fax:714-485-3024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-19
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty