Provider Demographics
NPI:1649200387
Name:SHAYGAN, FARNAZ (DC)
Entity Type:Individual
Prefix:DR
First Name:FARNAZ
Middle Name:
Last Name:SHAYGAN
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 1:1209 E YORBA LINDA BLVD
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-3830
Mailing Address - Country:US
Mailing Address - Phone:714-827-3833
Mailing Address - Fax:949-480-0733
Practice Address - Street 1:1209 E YORBA LINDA BLVD
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-3830
Practice Address - Country:US
Practice Address - Phone:714-827-3833
Practice Address - Fax:949-480-0733
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26493111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC26493Medicare ID - Type Unspecified