Provider Demographics
NPI:1952742819
Name:MCELHANON, SHAHIRA ELSHERIF
Entity Type:Individual
Prefix:
First Name:SHAHIRA
Middle Name:ELSHERIF
Last Name:MCELHANON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 PASEO CAMARILLO
Mailing Address - Street 2:SUITE 118
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6021
Mailing Address - Country:US
Mailing Address - Phone:805-482-3131
Mailing Address - Fax:
Practice Address - Street 1:1000 PASEO CAMARILLO
Practice Address - Street 2:SUITE 118
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6021
Practice Address - Country:US
Practice Address - Phone:805-482-3131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29050111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1205980067OtherGROUP NPI