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Individual
MICHAEL R SAMKO
Active
Individual
MICHAEL R SAMKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY5420
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00PL54200
BLUE SHIELD OF CALIFORNIA
CA
01
—
200505235
TRICARE
CA
Enumeration date
06/05/2008
Last updated
10/17/2018
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