Provider Demographics
NPI:1275549107
Name:SHUGART, CRAIG ALAN
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ALAN
Last Name:SHUGART
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 W MISSION ST
Mailing Address - Street 2:SUITE R
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-2426
Mailing Address - Country:US
Mailing Address - Phone:805-682-7779
Mailing Address - Fax:805-672-9387
Practice Address - Street 1:16 W MISSION ST
Practice Address - Street 2:SUITE R
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-2426
Practice Address - Country:US
Practice Address - Phone:805-682-7779
Practice Address - Fax:805-672-9387
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22466111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU58899Medicare UPIN