SAMUEL A. BOLIVAR MD INC NPI 1689082711

NPI Information

NPI: 1689082711
Provider Name: SAMUEL A. BOLIVAR, MD INC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
555 N D ST
SUITE 130
SAN BERNARDINO, CA
ZIP 92401
Phone: (909) 888-8154
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SAMUEL A. BOLIVAR, MD INC is a primary care clinic center in San Bernardino, CA. SAMUEL A. BOLIVAR, MD INC NPI is 1689082711. The provider is registered as an organization entity type.

The provider's business location address is:

555 N D ST
SUITE 130
SAN BERNARDINO, CA
ZIP 92401-305
Phone: (909) 888-8154
Fax: (909) 888-9940

The provider's authorized official is Barbara Bolivar .
The authorized official title is Administrator and has the following contact phone number (909) 888-8154.

The enumeration date for this NPI number is 8/1/2014 and was last updated on 4/27/2023.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	A41590	CALIFORNIA	Yes

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: 5/5/2024

NPI Synchronization or Removal

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