Provider Demographics
NPI:1770042004
Name:BARLOW, SAMUEL HYRUM (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:HYRUM
Last Name:BARLOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19582 BEACH BLVD STE 325
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-5923
Mailing Address - Country:US
Mailing Address - Phone:714-477-8020
Mailing Address - Fax:714-477-8072
Practice Address - Street 1:19582 BEACH BLVD STE 325
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-5923
Practice Address - Country:US
Practice Address - Phone:714-477-8020
Practice Address - Fax:714-477-8072
Is Sole Proprietor?:No
Enumeration Date:2019-03-16
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA179511207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine