Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Samantha Baltazar, PA

Individual provider Physician Assistant · NPI 1578176475

Samantha Baltazar, PA is a Physician Assistant in San Bernardino, California. Qualified in 2020, 6 years ago. Practices with Faculty Physicians and Surgeons of Llusm, a 1,308-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California and Nevada.

Years since qualifying
6
Licensed in
CA, NV
In the registry since
2020
Specialties on file
3
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

197 E Caroline St Ste 1400
San Bernardino, CA 92408-3731
Phone: (099) 558-3636
Fax: (909) 558-3754
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2020 Wellness Way Ste 506, Las Vegas, NV 89106-4145 — (702) 823-0004

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA58722 (CA)
Physician Assistant Taxonomy 363A00000X
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA3107 (NV)

Record details

NPI number1578176475
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedAugust 28, 2020
Last updated in NPPESNovember 14, 2024
Certification dateNovember 14, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Faculty Physicians And Surgeons Of Llusm — 1308 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in San Bernardino