Provider Demographics
NPI:1750551610
Name:THAWER, SHAFINA N (DC)
Entity type:Individual
Prefix:DR
First Name:SHAFINA
Middle Name:N
Last Name:THAWER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17203 VENTURA BLVD
Mailing Address - Street 2:STE 1
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-4051
Mailing Address - Country:US
Mailing Address - Phone:818-905-7233
Mailing Address - Fax:818-905-7727
Practice Address - Street 1:17203 VENTURA BLVD
Practice Address - Street 2:STE 1
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-4051
Practice Address - Country:US
Practice Address - Phone:818-905-7233
Practice Address - Fax:818-905-7727
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29316111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor