MEDICARE: DR. BARBARA SHUR DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC16862	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DC0168620	OTHER	CA	BLUE SHIELD LICENSE NO.

General Provider Information

NPI Number	:	1306875703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA SHUR DC

Provider Business Mailing Address
First Line	:	14340 BOLSA CHICA RD
Second Line	:	STE G
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-4868
Country	:	US
Telephone Number	:	562-795-6680
Fax Number	:

Provider Business Practice Location Address
First Line	:	14340 BOLSA CHICA RD STE G
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-4868
Country	:	US
Telephone Number	:	714-709-8030
Fax Number	:	562-799-9575

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	08/29/2018

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