Provider Demographics
NPI:1306875703
Name:SHUR, BARBARA (DC)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:SHUR
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 1:14340 BOLSA CHICA RD
Mailing Address - Street 2:STE G
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-4868
Mailing Address - Country:US
Mailing Address - Phone:562-795-6680
Mailing Address - Fax:
Practice Address - Street 1:14340 BOLSA CHICA RD STE G
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-4868
Practice Address - Country:US
Practice Address - Phone:714-709-8030
Practice Address - Fax:562-799-9575
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC16862111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0168620OtherBLUE SHIELD LICENSE NO.
CAWDC16862AMedicare ID - Type UnspecifiedMEDICARE LICENSE NO.
CAT18426Medicare UPIN