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General NPI Number Information
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NPI Number | 1902047202
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Entity Type | Individual
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Provider Name | RONALD STEVEN SHAW D.C.
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Gender | Male
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Dates
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Enumeration Date | 03/16/2009
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Last Update Date | 01/29/2018
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Provider Practice Location Address
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Address Line | 19350 BUSINESS CENTER DR
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City | NORTHRIDGE
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State | CA
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Zip | 91324-3500
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Country | US
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Telephone | 818-993-3668
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Fax |
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Provider Business Mailing Address
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Address Line | 627 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 |
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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 | DC-31188
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License Number State | CA
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