Provider Demographics
NPI:1760587489
Name:SEAN A. BARLOW, M.D.
Entity Type:Organization
Organization Name:SEAN A. BARLOW, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-674-9777
Mailing Address - Street 1:41990 COOK ST, BLDG. F, SUITE 2008
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211
Mailing Address - Country:US
Mailing Address - Phone:760-674-9777
Mailing Address - Fax:760-674-0355
Practice Address - Street 1:41990 COOK ST, BLDG F, SUITE 2008
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92234
Practice Address - Country:US
Practice Address - Phone:760-674-9777
Practice Address - Fax:760-674-0355
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEAN ARTHUR BARLOW, MD A PROFESSIONAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-14
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGO7824962084A0401X
CAG0782962084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR33BDC7Medicaid
CA33BDC7OtherMEDI-CAL
CAG33385Medicare UPIN
AR33BDC7Medicaid