MEDICARE: DR. SHAIDA MOSHREFI D.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NI0900X	Internist Chiropractor	26974	CA

General Provider Information

NPI Number	:	1457423436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAIDA MOSHREFI D.C

Provider Business Mailing Address
First Line	:	5225 CANYON CREST DRIVE SUITE 17
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92507
Country	:	US
Telephone Number	:	951-222-2002
Fax Number	:	952-686-8083

Provider Business Practice Location Address
First Line	:	5225 CANYON CREST DRIVE SUITE 17
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92507
Country	:	US
Telephone Number	:	951-222-2002
Fax Number	:	952-686-8083

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	09/20/2023

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