Etchie, Samuel O

Etchie, Samuel O is an individual health care provider with primary practice located at 7200 Parkway Dr Ste 113 , La Mesa CA 91942-1534. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Etchie, Samuel O can be contacted via phone (619) 337-0455.

Contact Information

Primary practice address
7200 Parkway Dr Ste 113 La Mesa CA 91942-1534
Fax: (619) 667-6059
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X A53857 California

Profile Details

NPI number 1124039052
LBN Legal business name Etchie, Samuel O
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Aug 23rd, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124039052 NPPES
California MEDICAID 00A538570

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