Individual
MICHAEL JOSEPH SAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
SWRMC 3601 WOMBLE ST, SAN DIEGO, CA 92136-0001
(619) 556-6641
(619) 556-9617
Mailing address
3601 WOMBLE ST, SAN DIEGO, CA 92136-0001
(619) 556-6641
(619) 556-9617
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
P0900513
—
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
04/09/2009
Last updated
04/09/2009
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