Healthcare Provider Details

I. General information

NPI: 1972430122
Provider Name (Legal Business Name): SHAWNEE HOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 S COAST DR
COSTA MESA CA
92626-1747
US

IV. Provider business mailing address

2355 WESTWOOD BLVD STE 257
LOS ANGELES CA
90064-2109
US

V. Phone/Fax

Practice location:
  • Phone: 949-544-9070
  • Fax:
Mailing address:
  • Phone: 949-544-9070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberKK201273
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: