Provider Demographics
NPI:1417915406
Name:SHAUL, DONALD BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:BRIAN
Last Name:SHAUL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 S MAIN ST STE 225
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4516
Mailing Address - Country:US
Mailing Address - Phone:714-364-4050
Mailing Address - Fax:
Practice Address - Street 1:505 S MAIN ST STE 225
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4516
Practice Address - Country:US
Practice Address - Phone:714-364-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG55169208800000X, 2086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G551690OtherMEDICAL ID NUMBER
CA10964OtherCCS NUMBER
CA00G551690OtherMEDICAL ID NUMBER