Provider Demographics
NPI:1568246304
Name:SHABOYAN, DIANA (DC)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:SHABOYAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 W ALAMEDA AVE STE 504
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4410
Mailing Address - Country:US
Mailing Address - Phone:818-510-3427
Mailing Address - Fax:818-510-3473
Practice Address - Street 1:2701 W ALAMEDA AVE STE 504
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4410
Practice Address - Country:US
Practice Address - Phone:818-510-3427
Practice Address - Fax:818-510-3473
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36398111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor