Samuel L. Wilson, M.D., Inc.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A21662 Issued in CA

Legal business name

SAMUEL L. WILSON, M.D., INC.

Practice address

1137 2ND St
Suite 111
Santa Monica, CA 90403-5011

Phone

(310) 395-9590

NPI assigned

May 15, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Samuel L. Wilson, M.D.NPI 1932240090

Title

Solo Practitioner

Phone

(310) 395-9590

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samuel Lamar Wilson, M.D.

  • Psychiatry Physician
  • Santa Monica, CA
  • NPI 1932240090
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337040000000",
    "number": "1962761668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 2ND ST",
            "address_2": "SUITE 111",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035011",
            "telephone_number": "310-395-9590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 2ND ST",
            "address_2": "SUITE 111",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035011",
            "telephone_number": "310-395-9590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL L. WILSON, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-15",
        "last_updated": "2012-05-15",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "SOLO PRACTITIONER",
        "authorized_official_telephone_number": "310-395-9590",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A21662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sameday Health
• Patrick Virgil Samones
• Stacey Sampo, LMFT
• Shamsher Singh Samra, MD
• Samuel I Miles MD a Professional Corporation
• Alan D Samuel, D.D.S.
• Noeman N Samuels, LMFT
• Francesca Marie Samuelson, CNM, WHNP-BC
• Jane San Juan, D.C., L.AC.
• Alba Sanchez

• Psychiatry Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.