Provider Demographics
NPI:1659350858
Name:ELMARIAH, SAMMY (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:SAMMY
Middle Name:
Last Name:ELMARIAH
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 MISSION BAY BLVD SOUTH
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143
Mailing Address - Country:US
Mailing Address - Phone:415-353-2873
Mailing Address - Fax:415-353-2528
Practice Address - Street 1:535 MISSION BAY BLVD SOUTH
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143
Practice Address - Country:US
Practice Address - Phone:415-353-2873
Practice Address - Fax:415-353-2528
Is Sole Proprietor?:No
Enumeration Date:2006-01-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC183269207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012691380001Medicaid
FE0798427OtherDEA
PA1012691380001Medicaid