Provider Demographics
NPI:1295262392
Name:SAINT PETER MEDICAL CENTER
Entity type:Organization
Organization Name:SAINT PETER MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LABEED
Authorized Official - Middle Name:SAMI
Authorized Official - Last Name:NOURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-332-8484
Mailing Address - Street 1:330 S MAGNOLIA AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-5224
Mailing Address - Country:US
Mailing Address - Phone:619-332-8484
Mailing Address - Fax:619-332-8488
Practice Address - Street 1:330 S MAGNOLIA AVE STE 302
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-5224
Practice Address - Country:US
Practice Address - Phone:619-332-8484
Practice Address - Fax:619-332-8488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty