Provider Demographics
NPI:1720140106
Name:SAMS CHIROPRACTIC CENTER INC
Entity Type:Organization
Organization Name:SAMS CHIROPRACTIC CENTER INC
Other - Org Name:DR BARON SAMS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:BARON
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:SAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:858-569-0959
Mailing Address - Street 1:5151 MURPHY CANYON RD.
Mailing Address - Street 2:#200
Mailing Address - City:SAN DIEGO
Mailing Address - State:CALIFORNIA
Mailing Address - Zip Code:92123
Mailing Address - Country:UM
Mailing Address - Phone:858-569-6959
Mailing Address - Fax:858-569-0240
Practice Address - Street 1:5151 MURPHY CANYON RD
Practice Address - Street 2:#200
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4440
Practice Address - Country:US
Practice Address - Phone:858-569-6959
Practice Address - Fax:858-569-0240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12045111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T04599Medicare UPIN
CADC12045Medicare PIN