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Individual

PHILIP MERRILL SAMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1140 MAIN ST, LIVINGSTON, CA 95334-1257
(209) 394-7913
(209) 394-9093
Mailing address
1140 MAIN ST, LIVINGSTON, CA 95334-1257
(209) 394-7913
(209) 394-9093

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
14693
CA
363AM0700X
Medical Physician Assistant
Primary
PA14693
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PA14693
CA
Enumeration date
08/25/2006
Last updated
10/24/2018
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