MEDICARE: MICHAEL SEAN SAMPSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	G84548	CA
2	207R00000X	Internal Medicine Physician	G84548	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568466100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL SEAN SAMPSON M.D.

Provider Business Mailing Address
First Line	:	3919 BEVERLY BLVD STE 203
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-3432
Country	:	US
Telephone Number	:	323-953-2956
Fax Number	:	323-913-2588

Provider Business Practice Location Address
First Line	:	3919 BEVERLY BLVD STE 203
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90004-3432
Country	:	US
Telephone Number	:	323-953-2956
Fax Number	:	323-913-2588

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	09/09/2024

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