MEDICARE: DR. JASON ALAN SHUMARD 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	111NR0400X	Rehabilitation Chiropractor	DC29400	CA

General Provider Information

NPI Number	:	1750590659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON ALAN SHUMARD D.C.

Provider Business Mailing Address
First Line	:	7094 MIRAMAR RD STE 109
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-2311
Country	:	US
Telephone Number	:	858-564-7081
Fax Number	:

Provider Business Practice Location Address
First Line	:	7094 MIRAMAR RD STE 109
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-2311
Country	:	US
Telephone Number	:	858-564-7081
Fax Number	:

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

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	08/12/2021

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