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

Samuela Fanua Jr., PA

Individual provider Physician Assistant · NPI 1518539196

Samuela Fanua Jr., PA is a Physician Assistant in Stockton, California. Qualified in 2022, 4 years ago. Practices with Stockton Cardiology Medical Group Complete Heart Care Inc, a 14-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth.

Years since qualifying
4
In the registry since
2021
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

415 E Harding Way Ste D
Stockton, CA 95204-6118
Phone: (209) 944-5750
Fax: (209) 464-2684
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1148 Norman Dr Ste 3, Manteca, CA 95336-5961 — (209) 824-1555
  • 1530 N Bessie Drive, Tracy, CA 95376-3080 — (209) 944-5750

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1518539196
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 13, 2021
Last updated in NPPESAugust 19, 2022
Certification dateAugust 17, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Stockton Cardiology Medical Group Complete Heart Care Inc — 14 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

Other providers in Stockton