Provider Demographics
NPI:1760409726
Name:SAMS, O'KEY (MD)
Entity Type:Individual
Prefix:
First Name:O'KEY
Middle Name:
Last Name:SAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7035 N CHESTNUT AVE
Mailing Address - Street 2:#103
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0352
Mailing Address - Country:US
Mailing Address - Phone:559-324-0700
Mailing Address - Fax:559-324-0701
Practice Address - Street 1:7035 N CHESTNUT AVE
Practice Address - Street 2:#103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0352
Practice Address - Country:US
Practice Address - Phone:559-324-0700
Practice Address - Fax:559-324-0701
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA055586207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A055586Medicaid
CA00A055586Medicaid
CAG25033Medicare UPIN