| NPI | 1124039052 |
|---|---|
| NPI Type | NPI-1 Individual |
| Status | Active |
| Enumeration Date | 2006-08-09 |
| Last Updated | 2018-08-23 |
| Mailing Address | 7770 Regents Rd, # 130 San Diego, CA 92122-1937 United States Phone: (619) 337-0455 | Fax: (619) 667-6059 📍 View Map |
| Primary Practice Address | 7200 Parkway Dr Ste 113 La Mesa, CA 91942-1534 United States Phone: (619) 337-0455 | Fax: (619) 667-6059 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| MEDICAID | CA | 00A538570 | — |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| Yes | 2084P0800X – Psychiatry & Neurology, Psychiatry | CA | A53857 |
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About NPI 1124039052
Samuel O Etchie M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1124039052. The primary specialty listed is Psychiatry & Neurology, Psychiatry. The provider is located in La Mesa, CA. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-08-09. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1124039052?
NPI 1124039052 belongs to Samuel O Etchie M.D., a Psychiatry & Neurology, Psychiatry in La Mesa, CA. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.
Is NPI 1124039052 active?
The current status of NPI 1124039052 in the NPPES registry is Active. The record was last updated on 2018-08-23.
What specialty is NPI 1124039052?
NPI 1124039052 is classified under the taxonomy Psychiatry & Neurology, Psychiatry. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1124039052?
You can verify NPI 1124039052 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1124039052?
The primary practice address on file for NPI 1124039052 is 7200 Parkway Dr Ste 113, La Mesa, CA 91942-1534. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1124039052 issued?
NPI 1124039052 was first issued (enumerated) on 2006-08-09. The NPPES record was last updated on 2018-08-23.
Practice Location Map
Samuel O Etchie is located at 7200 Parkway Dr Ste 113, La Mesa, CA. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Samuel O Etchie. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1124039052. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Psychiatry & Neurology, Psychiatry | A53857 | CA |