Provider Demographics
NPI:1275613184
Name:SVASTITS, STEPHEN JOHN (DC,CCSP,IDE)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JOHN
Last Name:SVASTITS
Suffix:
Gender:M
Credentials:DC,CCSP,IDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 401400
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92340-1400
Mailing Address - Country:US
Mailing Address - Phone:626-488-3326
Mailing Address - Fax:760-947-9215
Practice Address - Street 1:15664 MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-3412
Practice Address - Country:US
Practice Address - Phone:626-488-3326
Practice Address - Fax:760-947-9215
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 23698111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician