Provider Demographics
NPI:1932591724
Name:SAMEER OHRI MD INC
Entity Type:Organization
Organization Name:SAMEER OHRI MD INC
Other - Org Name:INNOVATIVE CARE MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMEER
Authorized Official - Middle Name:
Authorized Official - Last Name:OHRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-356-9992
Mailing Address - Street 1:818 MAGNOLIA AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3128
Mailing Address - Country:US
Mailing Address - Phone:951-356-9992
Mailing Address - Fax:951-595-4916
Practice Address - Street 1:818 MAGNOLIA AVE STE 201
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3128
Practice Address - Country:US
Practice Address - Phone:951-356-9992
Practice Address - Fax:951-595-4916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-03
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA105886207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty