Provider Demographics
NPI:1023108453
Name:SAMS, BARON ASHLEY (DC)
Entity type:Individual
Prefix:MR
First Name:BARON
Middle Name:ASHLEY
Last Name:SAMS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5151 MURPHY CANYON RD
Mailing Address - Street 2:200
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4440
Mailing Address - Country:US
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
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12045111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T04599Medicare UPIN