| Michael Samko, Ph.d., Inc. | |
|
2181 S El Camino Real Suite 201 Oceanside CA 92054-6220 | |
| (760) 721-1111 | |
| (760) 721-1116 |
| Full Name | Michael Samko, Ph.d., Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 2181 S El Camino Real, Oceanside, California |
| Authorized Official Name and Position | Michael R Samko (OWNER) |
| Authorized Official Contact | 7607211111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Samko, Ph.d., Inc. 2181 S El Camino Real Suite 201 Oceanside CA 92054-6220 Ph: (760) 721-1111 | Michael Samko, Ph.d., Inc. 2181 S El Camino Real Suite 201 Oceanside CA 92054-6220 Ph: (760) 721-1111 |
| NPI Number | 1740232727 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1658311998 |
|---|---|
| Medicare Enrollment ID | O20051130000811 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740232727 | NPI | - | NPPES |
| P00203711 | Other | CA | RAILROAD MEDICARE ID |
| 00PL54200 | Other | CA | BLUE SHIELD OF CALIFORNIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY5420 (California) | Primary |
| Provider Name | Michael R Samko |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396904165 PECOS PAC ID: 3173579265 Enrollment ID: I20051201000513 |
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