Provider Demographics
NPI:1710201249
Name:SHURE, CHELSEA (CD(DONA), HCHD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:SHURE
Suffix:
Gender:F
Credentials:CD(DONA), HCHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4290 REVERE PL
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-3241
Mailing Address - Country:US
Mailing Address - Phone:310-428-7302
Mailing Address - Fax:
Practice Address - Street 1:4290 REVERE PL
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-3241
Practice Address - Country:US
Practice Address - Phone:310-428-7302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-26
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator