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General NPI Number Information
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NPI Number | 1891925202
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Entity Type | Organization
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Legal Business Name | STEVEN SHAW CHIROPRACTIC INC.
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Dates
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Enumeration Date | 07/20/2009
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Last Update Date | 07/20/2009
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Provider Practice Location Address
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Address Line | 265 E. ORANGE GROVE AVE. SUITE C
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City | BURBANK
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State | CA
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Zip | 91502-1229
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Country | US
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Telephone | 818-556-5433
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Fax |
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Provider Business Mailing Address
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Address Line | 627 W. ARDEN AVE.
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City | GLENDALE
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State | CA
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Zip | 91202-2856
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Country | US
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Telephone | 818-219-2600
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD STEVEN SHAW
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Credential | D.C.
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Telephone | 818-219-2600
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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 | DC-31188
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License Number State | CA
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