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
Phone: (619) 337-0455
Fax: (619) 667-6059
Website:
Health care specialties
| Specialty | Code | License # | 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 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124039052 | NPPES |
| California | MEDICAID | 00A538570 |
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