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General NPI Number Information
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NPI Number | 1366883951
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Entity Type | Organization
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Legal Business Name | SHIVAWN INC.
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Dates
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Enumeration Date | 07/11/2013
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Last Update Date | 07/11/2013
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Provider Practice Location Address
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Address Line | 12062 VALLEY VIEW ST STE 205
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City | GARDEN GROVE
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State | CA
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Zip | 92845-1739
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Country | US
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Telephone | 714-747-9111
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Fax | 888-506-1966
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Provider Business Mailing Address
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Address Line | 6422 FERNE AVE
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City | CYPRESS
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State | CA
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Zip | 90630-4818
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Country | US
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Telephone | 714-747-9111
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Fax | 888-506-1966
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID SANDHU
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Credential | RN, BSN, PHN, CCM
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Telephone | 714-747-9111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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