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Individual

DAVID SAMUELSON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
12401 WASHINGTON BLVD, WHITTIER, CA 90602-1006
(562) 698-0811
(818) 587-2493
Mailing address
PO BOX 4419, WOODLAND HILLS, CA 91365-4419
(800) 506-6895
(818) 587-2493

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA15510
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00189346
RAILROAD MEDICARE
CA
05
PA15510
CA
Enumeration date
06/16/2006
Last updated
07/08/2007
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