| Samuel L. Wilson, M.d., Inc. | |
|
1137 2nd St Suite 111 Santa Monica CA 90403-5011 | |
| (310) 395-9590 | |
| Not Available |
| Full Name | Samuel L. Wilson, M.d., Inc. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1137 2nd St, Santa Monica, California |
| Authorized Official Name and Position | Samuel L. Wilson (SOLO PRACTITIONER) |
| Authorized Official Contact | 3103959590 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Samuel L. Wilson, M.d., Inc. 1137 2nd St Suite 111 Santa Monica CA 90403-5011 Ph: (310) 395-9590 | Samuel L. Wilson, M.d., Inc. 1137 2nd St Suite 111 Santa Monica CA 90403-5011 Ph: (310) 395-9590 |
| NPI Number | 1962761668 |
|---|---|
| Provider Enumeration Date | 05/15/2012 |
| Last Update Date | 05/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962761668 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | A21662 (California) | Primary |
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