Provider Demographics
NPI:1407023617
Name:JUST, SHAUN P (DC)
Entity Type:Individual
Prefix:DR
First Name:SHAUN
Middle Name:P
Last Name:JUST
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 1:800 MAGNOLIA AVE
Mailing Address - Street 2:STE. 109
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-3123
Mailing Address - Country:US
Mailing Address - Phone:951-279-6616
Mailing Address - Fax:951-279-6815
Practice Address - Street 1:800 MAGNOLIA AVE
Practice Address - Street 2:STE. 109
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3123
Practice Address - Country:US
Practice Address - Phone:951-279-6616
Practice Address - Fax:951-279-6815
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-27782111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor