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Organization
SAMUEL L. WILSON, M.D., INC.
Active
Organization
SAMUEL L. WILSON, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL L. WILSON M.D. (SOLO PRACTITIONER)
(310) 395-9590
Entity
Organization
Contact information
Practice address
1137 2ND ST, SUITE 111, SANTA MONICA, CA 90403-5011
(310) 395-9590
Mailing address
1137 2ND ST, SUITE 111, SANTA MONICA, CA 90403-5011
(310) 395-9590
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A21662
CA
Other
Enumeration date
05/15/2012
Last updated
05/15/2012
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