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General NPI Number Information
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NPI Number | 1275613184
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Entity Type | Individual
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Provider Name | STEPHEN JOHN SVASTITS D.C.,C.C.S.P.,I.D.E.
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Gender | Male
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 15664 MAIN ST STE 100
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City | HESPERIA
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State | CA
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Zip | 92345-3412
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Country | US
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Telephone | 626-488-3326
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Fax | 760-947-9215
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Provider Business Mailing Address
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Address Line | PO BOX 401400
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City | HESPERIA
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State | CA
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Zip | 92340-1400
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Country | US
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Telephone | 626-488-3326
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Fax | 760-947-9215
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | DC 23698
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License Number State | CA
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