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Organization
MICHAEL SAMKO, PH.D., INC.
Active
Organization
MICHAEL SAMKO, PH.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL R SAMKO PH.D. (OWNER)
(760) 721-1111
Entity
Organization
Contact information
Practice address
2181 S EL CAMINO REAL, SUITE 201, OCEANSIDE, CA 92054-6220
(760) 721-1111
(760) 721-1116
Mailing address
2181 S EL CAMINO REAL, SUITE 201, OCEANSIDE, CA 92054-6220
(760) 721-1111
(760) 721-1116
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
—
P00203711
RAILROAD MEDICARE ID
CA
Enumeration date
05/17/2006
Last updated
08/22/2020
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