Provider Demographics
NPI:1811903172
Name:PATRICK FRANCIS SHEEHY AND ARLENE GWON MDS INC
Entity type:Organization
Organization Name:PATRICK FRANCIS SHEEHY AND ARLENE GWON MDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:SHEEHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-640-8620
Mailing Address - Street 1:1401 AVOCADO
Mailing Address - Street 2:#903
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7771
Mailing Address - Country:US
Mailing Address - Phone:949-640-8620
Mailing Address - Fax:949-640-6660
Practice Address - Street 1:1401 AVOCADO
Practice Address - Street 2:#903
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7771
Practice Address - Country:US
Practice Address - Phone:949-640-8620
Practice Address - Fax:949-640-6660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA25277207RH0003X
CAG22586207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Not Answered207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A24355Medicare UPIN
W4311Medicare ID - Type Unspecified