Provider Demographics
NPI:1174654800
Name:ROBEK, SHAWN KEVIN (DC)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:KEVIN
Last Name:ROBEK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 CAMINO DE LA SIESTA STE 404
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3120
Mailing Address - Country:US
Mailing Address - Phone:619-295-9791
Mailing Address - Fax:619-297-6901
Practice Address - Street 1:11333 N SCOTTSDALE RD STE 140
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5190
Practice Address - Country:US
Practice Address - Phone:619-295-9791
Practice Address - Fax:619-295-9792
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 26307111N00000X
AZ8776111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor