MR. SAM SOM (NPI# 1316084312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316084312 |
| Entity Type | Individual |
| Full Name | MR. SAM SOM |
| Credential | FNP-C |
| Practice Address |
17330 Bear Valley Rd Suite A 106 Victorville CA 92395-7741 |
| Practice Telephone | 7602459999 |
| Practice Fax Number | 7602458855 |
| Mailing Telephone | 7602459999 |
| Mailing Fax Number | 7602458855 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2014-07-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
559654 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
17330 BEAR VALLEY RD SUITE A 106 |
| City | VICTORVILLE |
| State | CA |
| Zip Code | 92395-7741 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770527095 | Navdeep Loomba | Anesthesiology | 17330 Bear Valley Rd, Suite A106, Victorville, CA 92395-7741 | 2006-06-16 |
| 1609244664 | Bradley Toews | Physician Assistant | 17330 Bear Valley Rd, Victorville, CA 92395-7741 | 2015-09-08 |
| 1225261027 | Don W Jeske | Registered Nurse | 17330 Bear Valley Rd, Victorville, CA 92395-7741 | 2009-08-26 |
| 1750501250 | Victor F. Sulit | Preventive Medicine | 17330 Bear Valley Rd, Suite 106 A, Victorville, CA 92395-7741 | 2007-04-26 |
| 1114957602 | Gabriel L Stine | Chiropractor | 17330 Bear Valley Rd, Ste 105, Victorville, CA 92395 | 2006-07-03 |
| 1538198411 | Raychelle Deermer-kemple | Chiropractor | 17330 Bear Valley Rd, Ste 105, Victorville, CA 92395 | 2006-07-02 |
| 1982633863 | Gabriel L Stine Dc | Chiropractor | 17330 Bear Valley Rd, Ste 105, Victorville, CA 92395 | 2006-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837966 | Desert Ridge Transitional Care Center, Lp | Skilled Nursing Facility | 13300 11th Avenue, Victorville, CA 92395 | 2020-06-26 |
| 1376179093 | Catherine Ward | Speech-Language Pathologist | 13275 Mauka Ct, Victorville, CA 92395 | 2020-03-13 |
| 1174019228 | Laura Mercado Halterman | Family Medicine | 16519 Victor St Ste 307, Victorville, CA 92395 | 2018-07-02 |
| 1306337829 | Stephanie Ann Kruger | Behavior Technician | Sunny Days Inc 3602 Inland Empire Blvd., Ontario, CA 92395 | 2018-05-21 |
| 1861903924 | Debra L Andersen | Clinic/Center | 12830 Hesperia Road, Suite C, D, E, Victorville, CALIFORNIA 92395 | 2017-10-17 |
| 1790202141 | Joshua Powers | Physician Assistant | 12550 Hesperia Rd Ste 101, Victorville, CA 92395 | 2017-08-26 |
| 1043759491 | Kemp Individual & Family Therapy, Inc. | Marriage & Family Therapist | 14075 Hesperia Road, Suite 101, Victorville, CA 92395 | 2017-02-17 |
| 1740725969 | Abem Transportation Inc | Non-emergency Medical Transport (VAN) | 15000 7th St Ste F208, Victorville, CA 92395 | 2016-12-23 |
| 1447669379 | Tracie Girard | Nurse Practitioner | 17330 Bear Valley Road, Suite A106, Victorville, CA 92395 | 2014-08-05 |
| 1093153215 | Mitesh Patel | Surgery | 13010 Hesperia Rd Ste 400, Victorville, CA 92395 | 2013-06-10 |
| Find all providers in zip 92395 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548883002 | Karmen Padfield | Nurse Practitioner | 18172 Kalin Ranch Dr., Victorville, CA 92395-5133 | 2020-05-19 |
| 1164905451 | Bernadette Johns | Nurse Practitioner | 12127 Mall Blvd # 148, Victorville, CA 92392-7665 | 2018-09-12 |
| 1588158711 | Ester Victoria Barraza | Nurse Practitioner | 17259 Jasmine St Ste B, Victorville, CA 92395-7787 | 2018-06-20 |
| 1104313402 | Jorge L Soler Iglesias | Nurse Practitioner | 12459 Cricket St., Victorville, CA 92392 | 2018-04-23 |
| 1447752845 | Warren Sloan | Nurse Practitioner | 12550 Hesperia Rd # 101, Victorville, CA 92395-5873 | 2018-03-02 |
| 1689192049 | Jamesina Johns | Nurse Practitioner | 12127 Mall Blvd #148, Victorville, CA 92392 | 2017-09-06 |
| 1871027565 | Rhonita Henry | Nurse Practitioner | 15610 Bear Valley Rd, Victorville, CA 92395-8822 | 2017-04-19 |
| 1932551942 | Anna Cortes | Nurse Practitioner | 17259 Jasmine St Ste A, Victorville, CA 92395-7787 | 2016-07-01 |
| 1003211566 | Bukola Gross | Nurse Practitioner | 13010 Hesperia Rd Ste 501, Victorville, CA 92395-8315 | 2014-10-27 |
| 1447669379 | Tracie Girard | Nurse Practitioner | 17330 Bear Valley Road, Suite A106, Victorville, CA 92395 | 2014-08-05 |
| Find all providers in VICTORVILLE | ||||
| City | VICTORVILLE |
| Zip Code | 92395 |
Please comment or provide details below to improve the information on MR. SAM SOM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.