Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 22466 | CA |
NPI | 1275549107 |
---|---|
Provider Name | Dr. Craig Alan Shugart |
First Address | Santa Barbara, CA 93101-2426 |
Second Address | Santa Barbara, CA 93101-2426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U58899 | (02) | CA |