Provider Demographics
NPI:1518241868
Name:SHON, JAMES (LAC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:SHON
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 S, JEFFERSON ST #D
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870
Mailing Address - Country:US
Mailing Address - Phone:714-336-6608
Mailing Address - Fax:
Practice Address - Street 1:1111 N. BRISTOL #J
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92703
Practice Address - Country:US
Practice Address - Phone:714-434-6875
Practice Address - Fax:714-434-1096
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14206171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist