Active NPI
Bruce Shannahoff, D.C.
- Chiropractor
- Encino, CA
National Provider Identifier
1083736854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 15683
- Practice address
- 5363 Balboa Blvd Ste 430
Encino, CA 91316-2837 - Phone
- (818) 789-3244
- Fax
- (253) 390-2518
- NPI assigned
- Apr 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 15683 | CA | Primary |
Addresses
Primary practice location
5363 Balboa Blvd Ste 430
Encino, CA 91316-2837
Mailing address
5363 Balboa Blvd Ste 430
Encino, CA 91316-2837
Phone (818) 789-3244
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15683 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083736854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5363 BALBOA BLVD STE 430",
"city": "ENCINO",
"state": "CA",
"postal_code": "913162837",
"telephone_number": "818-789-3244",
"fax_number": "253-390-2518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5363 BALBOA BLVD STE 430",
"city": "ENCINO",
"state": "CA",
"postal_code": "913162837",
"telephone_number": "818-789-3244",
"fax_number": "253-390-2518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANNAHOFF",
"first_name": "BRUCE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "15683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Encino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.