Provider Demographics
NPI:1710016704
Name:SHAHIN, PAYMAN (DC)
Entity Type:Individual
Prefix:
First Name:PAYMAN
Middle Name:
Last Name:SHAHIN
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 1:2130 N TUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-7828
Mailing Address - Country:US
Mailing Address - Phone:949-981-4114
Mailing Address - Fax:714-544-8855
Practice Address - Street 1:2130 N TUSTIN AVE
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-7828
Practice Address - Country:US
Practice Address - Phone:714-544-1600
Practice Address - Fax:714-544-8855
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-30523111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor