Healthcare Provider Details

I. General information

NPI: 1063156263
Provider Name (Legal Business Name): NATHANIEL NASH SHON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2022
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 E 7TH ST
LONG BEACH CA
90822-5201
US

IV. Provider business mailing address

984120 NEBRASKA MEDICAL CTR
OMAHA NE
68198-4120
US

V. Phone/Fax

Practice location:
  • Phone: 562-862-8000
  • Fax:
Mailing address:
  • Phone: 402-559-8700
  • Fax: 402-559-5080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number1063156263
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: