| Doctor Name: | ELIZABETH A SAMUELS |
| NPI Number: | 1053369439 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 684081 |
| Business Practice Address: | 7592 Broadway Lemon Grove Family Health Center Lemon Grove, CA - 91945 |
| Business Phone Number: | 6195152550 |
| Business Fax Number: | 6193370525 |
| Mailing Address: | 823 Gateway Center Way, SAN DIEGO |
| State: | CA |
| Postal Code: | 921024541 |
| Phone Number: | 6195152323 |
| Fax Number: | 6199064564 |
| NPI Enumeration Date: | 05/05/2006 |
| NPI Last Update Date: | 10/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 684081 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |