Individual
SAMUEL DOCTORIAN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S.
Contact information
Practice address
901 E ALOSTA AVE, AZUSA, CA 91702-2701
(626) 969-3434
Mailing address
1215 REXFORD AVE, PASADENA, CA 91107-1714
(626) 319-6262
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/01/2018
Last updated
07/01/2018
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