Individual
SAM FILICIOTTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15708 POMERADO RD, SUITE N 207, POWAY, CA 92064-2066
(858) 487-8741
Mailing address
15708 POMERADO RD, SUITE N-207, POWAY, CA 92064-2066
(858) 487-8741
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G65491
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G654911
—
CA
Enumeration date
03/30/2006
Last updated
06/28/2016
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