MEDICARE: SHAWN IVAN HAYES D.C.

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	DC198240	CA

General Provider Information

NPI Number	:	1891872495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWN IVAN HAYES D.C.

Provider Business Mailing Address
First Line	:	750 SPAANS DR
Second Line	:	SUITE A
City	:	GALT
State	:	CA
Zip	:	95632-8609
Country	:	US
Telephone Number	:	209-745-6639
Fax Number	:	209-745-5918

Provider Business Practice Location Address
First Line	:	750 SPAANS DR
Second Line	:	SUITE A
City	:	GALT
State	:	CA
Zip	:	95632-8609
Country	:	US
Telephone Number	:	209-745-6639
Fax Number	:	209-745-5918

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	12/06/2012

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Directions to “ SHAWN IVAN HAYES D.C.” Practice Location

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