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Individual

SAMUEL DOUGLAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
3300 WEBSTER ST STE 703, OAKLAND, CA 94609-3122
(510) 835-5633
Mailing address
515 VERNON ST APT 203, OAKLAND, CA 94610-1402
(510) 292-8669

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
300980
CA

Other

Enumeration date
10/12/2021
Last updated
10/18/2021
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