Provider Demographics
NPI:1154578565
Name:FURST, SHAWN ROBERT (DO)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:ROBERT
Last Name:FURST
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 W EAST AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-7238
Mailing Address - Country:US
Mailing Address - Phone:530-332-3277
Mailing Address - Fax:530-893-6978
Practice Address - Street 1:340 W EAST AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-7238
Practice Address - Country:US
Practice Address - Phone:530-332-3277
Practice Address - Fax:530-893-6978
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2015-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008018701208100000X
UT8206969-1204208100000X
CA20A 12926208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation