Provider Demographics
NPI:1740364140
Name:SHAHANI, RISHI (DC)
Entity type:Individual
Prefix:DR
First Name:RISHI
Middle Name:
Last Name:SHAHANI
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 1:3622 THORNTON AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-7400
Mailing Address - Country:US
Mailing Address - Phone:510-505-0100
Mailing Address - Fax:510-405-9211
Practice Address - Street 1:3622 THORNTON AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-7400
Practice Address - Country:US
Practice Address - Phone:510-505-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30298111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor