Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | C-35190 | CA |
NPI | 1225314487 |
---|---|
Provider Name | Dr. Joel M Samuels |
First Address | San Francisco, CA 94110-2209 |
Second Address | San Francisco, CA 94110-2209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2011 |
Last Update Date | 01/11/2011 |