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General NPI Number Information
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NPI Number | 1619043106
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Entity Type | Individual
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Provider Name | RAMIN SHIVA D.C.
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Gender | Male
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 05/16/2018
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Provider Practice Location Address
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Address Line | 400 N SAN MATEO DR # 1
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City | SAN MATEO
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State | CA
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Zip | 94401
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Country | US
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Telephone | 650-579-7246
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Fax |
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Provider Business Mailing Address
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Address Line | 3182 CAMPUS DR # 225
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City | SAN MATEO
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State | CA
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Zip | 94403-3123
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Country | US
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Telephone | 650-579-7246
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC29530
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License Number State | CA
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