Provider Demographics
NPI:1114387651
Name:SHAWN URAINE MD INC.
Entity Type:Organization
Organization Name:SHAWN URAINE MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:URAINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-260-0580
Mailing Address - Street 1:PO BOX 119
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-0119
Mailing Address - Country:US
Mailing Address - Phone:909-333-4200
Mailing Address - Fax:909-333-4205
Practice Address - Street 1:25805 BARTON RD
Practice Address - Street 2:STE. A106
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-3814
Practice Address - Country:US
Practice Address - Phone:909-333-4200
Practice Address - Fax:909-333-4205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-25
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty