Healthcare Provider Details

I. General information

NPI: 1386896223
Provider Name (Legal Business Name): SHAHINIAN ESPELETA PULMONARY ASSOCIATES INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2008
Last Update Date: 05/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24411 HEALTH CENTER DR STE 620
LAGUNA HILLS CA
92653-3651
US

IV. Provider business mailing address

25467 NELLIE GAIL RD
LAGUNA HILLS CA
92653-6306
US

V. Phone/Fax

Practice location:
  • Phone: 949-521-6060
  • Fax: 949-521-6063
Mailing address:
  • Phone: 949-521-6060
  • Fax: 949-521-6063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. GEORGE KEVORK SHAHINIAN
Title or Position: OWNER / PHYSICIAN
Credential: M.D.
Phone: 949-521-6060