Healthcare Provider Details

I. General information

NPI: 1649782715
Provider Name (Legal Business Name): FLOYD G SHON MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 10/25/2024
Certification Date: 10/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 CREEK ROAD, STE 130
IRVINE CA
92604
US

IV. Provider business mailing address

37 CREEK ROAD, STE 130
IRVINE CA
92604-8053
US

V. Phone/Fax

Practice location:
  • Phone: 949-855-2772
  • Fax: 949-612-9171
Mailing address:
  • Phone: 949-855-2772
  • Fax: 949-612-9171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberG85470
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberG85470
License Number StateCA

VIII. Authorized Official

Name: DR. FLOYD G SHON
Title or Position: CEO
Credential: MD
Phone: 949-855-2772