Shannon, Maryellen Kathryn
Shannon, Maryellen Kathryn is an individual health care provider with primary practice located at 6 Hughes Ste 100, Irvine CA 92618-2059. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Shannon, Maryellen Kathryn can be contacted via phone (949) 680-1880.Contact Information
Primary practice address
6 Hughes Ste 100
Irvine CA 92618-2059
Phone: (949) 680-1880
Fax: (949) 680-1881
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | AZ19717 | Arizona |
Profile Details
| NPI number | 1033227483 |
|---|---|
| LBN Legal business name | Shannon, Maryellen Kathryn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 27th, 2006 |
| Last updated | Jan 2nd, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033227483 | NPPES |
| Arizona | MEDICAID | 04886 |
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