Provider Demographics
NPI:1932592508
Name:SAMS, BARON TYLER (DC)
Entity Type:Individual
Prefix:DR
First Name:BARON
Middle Name:TYLER
Last Name:SAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 MURPHY CANYON RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4339
Mailing Address - Country:US
Mailing Address - Phone:858-569-6959
Mailing Address - Fax:
Practice Address - Street 1:5151 MURPHY CANYON RD STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4339
Practice Address - Country:US
Practice Address - Phone:858-569-6959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-06
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33216111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor