Provider Demographics
NPI:1942312384
Name:SHIGEMOTO, STEVEN THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:THOMAS
Last Name:SHIGEMOTO
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 1:2370 E BIDWELL ST
Mailing Address - Street 2:SUITE 130
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3892
Mailing Address - Country:US
Mailing Address - Phone:916-983-2359
Mailing Address - Fax:916-983-2671
Practice Address - Street 1:2370 E BIDWELL ST
Practice Address - Street 2:SUITE 130
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3892
Practice Address - Country:US
Practice Address - Phone:916-983-2359
Practice Address - Fax:916-983-2671
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC27862111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0278621Medicare UPIN