Provider Demographics
NPI:1528180544
Name:SHAMOUN, JOHN M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:SHAMOUN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:366 SAN MIGUEL DR STE 310
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7810
Mailing Address - Country:US
Mailing Address - Phone:949-759-3077
Mailing Address - Fax:949-759-3087
Practice Address - Street 1:366 SAN MIGUEL DR STE 310
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7810
Practice Address - Country:US
Practice Address - Phone:949-759-3077
Practice Address - Fax:949-759-3087
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2020-03-06
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Provider Licenses
StateLicense IDTaxonomies
CAA052955208200000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery