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NPI Code Detail

MEDICARE: JACK A SHOHET M.D.

MEDICARE: JACK A SHOHET 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
1207YX0901XOtology & Neurotology PhysicianG54420CA
2174400000XSpecialistG83612CA

General Provider Information

NPI Number : 1346325180
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACK A SHOHET M.D.
Provider Business Mailing Address
First Line : 446 OLD NEWPORT BLVD
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92663-4246
Country : US
Telephone Number : 949-631-4327
Fax Number : 949-631-2030
Provider Business Practice Location Address
First Line : 446 OLD NEWPORT BLVD
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92663-4246
Country : US
Telephone Number : 949-631-0409
Fax Number : 949-631-2030
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2006
Last Update Date : 09/16/2019

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Directions to “ JACK A SHOHET M.D.” Practice Location

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