Provider Demographics
NPI:1407999170
Name:SAMSON, ROBERT L (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:SAMSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5375 FREMANTLE LN
Mailing Address - Street 2:#114
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-3113
Mailing Address - Country:US
Mailing Address - Phone:818-888-1430
Mailing Address - Fax:818-880-4799
Practice Address - Street 1:5375 FREMANTLE LANE
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302
Practice Address - Country:US
Practice Address - Phone:818-888-1430
Practice Address - Fax:818-888-7430
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA24781207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24781Medicare UPIN
CAA24781Medicare UPIN