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General NPI Number Information
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NPI Number | 1942474366
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Entity Type | Organization
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Legal Business Name | SHAWN COUTURE MD INC
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 6848 MAGNOLIA AVE SUITE 230
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City | RIVERSIDE
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State | CA
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Zip | 92506-2857
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Country | US
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Telephone | 951-689-2991
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Fax | 951-682-9912
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Provider Business Mailing Address
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Address Line | 6848 MAGNOLIA AVE SUITE 230
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City | RIVERSIDE
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State | CA
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Zip | 92506-2857
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Country | US
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Telephone | 951-682-9911
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Fax | 951-682-9912
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHAWN COUTURE
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Credential | M.D.
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Telephone | 951-682-9911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A98305
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License Number State | CA
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