Provider Demographics
NPI:1366883951
Name:SHIVAWN INC.
Entity type:Organization
Organization Name:SHIVAWN INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDHU
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, PHN, CCM
Authorized Official - Phone:714-747-9111
Mailing Address - Street 1:6422 FERNE AVE
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-4818
Mailing Address - Country:US
Mailing Address - Phone:714-747-9111
Mailing Address - Fax:888-506-1966
Practice Address - Street 1:12062 VALLEY VIEW ST STE 205
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845-1739
Practice Address - Country:US
Practice Address - Phone:714-747-9111
Practice Address - Fax:888-506-1966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care