Organization
SAM FILICIOTTO, MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM FILICIOTTO MD (PRESIDENT)
(858) 487-8741
Entity
Organization
Contact information
Practice address
15708 POMERADO RD STE N-207, POWAY, CA 92064-2066
(858) 487-8741
(858) 487-8744
Mailing address
15708 POMERADO RD STE N-207, POWAY, CA 92064-2066
(858) 487-8741
(858) 487-8744
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G65491
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0559323
MEDI-CAL PIN
CA
01
—
1881655744
FORMER NPI SOLE PROPIETOR
CA
Enumeration date
08/27/2014
Last updated
08/27/2014
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