MEDICARE: DR. JONATHAN MOU JUN SHIAU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	143632	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134407166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN MOU JUN SHIAU M.D.

Provider Business Mailing Address
First Line	:	280 NEWPORT CENTER DR STE 235
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-7524
Country	:	US
Telephone Number	:	949-593-6797
Fax Number	:	949-276-3221

Provider Business Practice Location Address
First Line	:	280 NEWPORT CENTER DR STE 235
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-7524
Country	:	US
Telephone Number	:	949-593-6797
Fax Number	:	949-276-3221

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2011
Last Update Date	:	03/23/2026

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