Provider Demographics
NPI:1356136808
Name:BAUMANN, SHANE (DC)
Entity type:Individual
Prefix:
First Name:SHANE
Middle Name:
Last Name:BAUMANN
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11743 TRISTAN DR
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-5221
Mailing Address - Country:US
Mailing Address - Phone:562-965-1896
Mailing Address - Fax:
Practice Address - Street 1:7146 EDINGER AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3568
Practice Address - Country:US
Practice Address - Phone:714-377-4313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37139111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor