Provider Demographics
NPI:1013099514
Name:YARMO, SHAWN (DC)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:YARMO
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 1:12626 RIVERSIDE DR STE 511
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3458
Mailing Address - Country:US
Mailing Address - Phone:818-980-0200
Mailing Address - Fax:818-980-3303
Practice Address - Street 1:12626 RIVERSIDE DR STE 511
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91607-3458
Practice Address - Country:US
Practice Address - Phone:818-980-0200
Practice Address - Fax:818-980-3303
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC18702111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC18702Medicare PIN
CAT82699Medicare UPIN