Healthcare Provider Details
I. General information
NPI: 1396752432
Provider Name (Legal Business Name): FLOYD GILBERT SHON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/02/2006
Last Update Date: 10/31/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
37 CREEK RD STE 130
IRVINE CA
92604-4724
US
IV. Provider business mailing address
37 CREEK RD STE 130
IRVINE CA
92604-4724
US
V. Phone/Fax
- Phone: 949-855-2772
- Fax: 949-612-9171
- Phone: 949-855-2772
- Fax: 949-612-9171
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | G85470 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | G85470 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: