| Shea Family Chiropractic Apc | |
|
11770 Bernardo Plaza Ct Ste 351 San Diego CA 92128-2426 | |
| (858) 312-5066 | |
| Not Available |
| Full Name | Shea Family Chiropractic Apc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11770 Bernardo Plaza Ct Ste 351, San Diego, California |
| Authorized Official Name and Position | Devin Shea (PRESIDENT/CEO) |
| Authorized Official Contact | 8583125066 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shea Family Chiropractic Apc 11770 Bernardo Plaza Ct Ste 351 San Diego CA 92128-2426 Ph: () - | Shea Family Chiropractic Apc 11770 Bernardo Plaza Ct Ste 351 San Diego CA 92128-2426 Ph: (858) 312-5066 |
| NPI Number | 1326507591 |
|---|---|
| Provider Enumeration Date | 03/18/2019 |
| Last Update Date | 06/11/2019 |
| Medicare PECOS PAC ID | 3375978406 |
|---|---|
| Medicare Enrollment ID | O20200120001231 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326507591 | NPI | - | NPPES |
| 1033361092 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Devin M Shea |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1033361092 PECOS PAC ID: 0547321408 Enrollment ID: I20081210000484 |
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