Individual
JASON SHUPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
554 E FOOTHILL BLVD STE 120, SAN DIMAS, CA 91773-1222
(909) 248-3437
(844) 380-6565
Mailing address
554 E FOOTHILL BLVD STE 120, SAN DIMAS, CA 91773-1222
(909) 248-3437
(844) 380-6565
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
20A13620
CA
207Q00000X
Family Medicine Physician
20A13620
CA
Other
Enumeration date
07/10/2013
Last updated
12/01/2021
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