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:
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Health care specialties

SpecialtyCodeLicense #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 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033227483 NPPES
Arizona MEDICAID 04886

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