Provider Demographics
NPI:1306953484
Name:SAMSON, RONALD PAUL (MED, ATC)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:PAUL
Last Name:SAMSON
Suffix:
Gender:M
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:511 DEL VALLE AVE
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744-3014
Mailing Address - Country:US
Mailing Address - Phone:626-736-7658
Mailing Address - Fax:
Practice Address - Street 1:1800 E LAMBERT RD
Practice Address - Street 2:STE 220
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-4370
Practice Address - Country:US
Practice Address - Phone:714-256-5074
Practice Address - Fax:714-256-0770
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2014-07-09
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer