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SAMUEL IM M.D. NPI 1790839496


NPI Information

NPI: 1790839496
Provider Name: SAMUEL IM, M.D.
Classification: Obstetrics & Gynecology - 207VX0201X
Entity Type: Individual

Specialization: Gynecologic Oncology

PECOS Registration: Yes

Address:
12462 PUTNAM ST
SUITE 303
WHITTIER, CA
ZIP 90602
Phone: (562) 900-1012
Get Directions

Samuel Im, M.D. is a gynecologic oncology obstetrics gynecology in Whittier, CA with 28 years of experience. The provider is an obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. Samuel Im, M.D. NPI is 1790839496. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduation Year:1996

The provider's business location address is:

12462 PUTNAM ST
SUITE 303
WHITTIER, CA
ZIP 90602-048
Phone: (562) 900-1012
Fax: (562) 789-4440

The NPI 1790839496 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/22/2007 and was last updated on 10/12/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207VX0201XObstetrics & GynecologyGynecologic OncologyA71341CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1WA71341FMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAPPIN
2H49953MEDICARE UPINCALIFORNIA
3WA71341GMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAPPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.