Most Relevant Information
Provider Data
| NPI Number: | 1003277856 |
| Provider Name: | SAMUEL WOOD |
| Entity Type: | Individual |
| Taxonomy Code: | 163WP0809X |
| Specialty: | Registered Nurse |
| License Number: | 95071479 |
Most Important Dates
| Enumeration Date: | 03/08/2016 |
| Last Updated: | 03/08/2016 |
Provider Practice Location
803 GROVE AVE
IMPERIAL BEACH
CA
91932
Practice Location Phone/Fax
| Phone: | 5174149304 |
| Fax: |
Provider Mailing Location
803 GROVE AVE
IMPERIAL BEACH
CA
91932
Provider Mailing Phone/Fax
| Phone: | 5174149304 |
| Fax: |