Agra, Samuel

Agra, Samuel is an individual health care provider with primary practice located at 1711 W Temple St 5606, Los Angeles CA 90026-5421. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Agra, Samuel can be contacted via phone (213) 989-6107.

Contact Information

Primary practice address
1711 W Temple St 5606 Los Angeles CA 90026-5421
Fax: (213) 483-5032
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X A54058 California

Profile Details

NPI number 1598719791
LBN Legal business name Agra, Samuel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated Nov 6th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598719791 NPPES
California MEDICAID 00A540581

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