Individual
JEFFREY WILLIAM WYLIE SAMUELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
2175 MARKET STREET, UNIT 122, SAN FRANCISCO, CA 94114-1477
(628) 895-9508
(628) 895-9509
Mailing address
1423 BROADWAY STE 122, OAKLAND, CA 94612-2054
(510) 984-4916
(510) 989-9089
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
134195
CA
Other
Enumeration date
04/08/2016
Last updated
09/26/2020
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