Provider Demographics
NPI:1831104694
Name:METYAS, SAMY K (MD)
Entity type:Individual
Prefix:DR
First Name:SAMY
Middle Name:K
Last Name:METYAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W SAN BERNARDINO RD STE A
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91722-3797
Mailing Address - Country:US
Mailing Address - Phone:626-966-1909
Mailing Address - Fax:626-966-2629
Practice Address - Street 1:500 W SAN BERNARDINO RD STE A
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-3797
Practice Address - Country:US
Practice Address - Phone:626-966-1909
Practice Address - Fax:626-966-2629
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72678207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A726780Medicaid
CA00A726780Medicaid
CAW16467AMedicare ID - Type Unspecified