Jonathan David Shifren, M.D.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

G75154 Issued in CA

Practice address

359 San Miguel Dr
Suite 206
Newport Beach, CA 92660-7812

Phone

(949) 729-1731

Fax

(949) 721-9194

NPI assigned

Jan 2, 2007

Last updated

Oct 18, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wave Medical Group Inc

  • Surgery Physician
  • Costa Mesa, CA
  • NPI 1306328265
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1144387952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "359 SAN MIGUEL DR",
            "address_2": "SUITE 206",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607812",
            "telephone_number": "949-729-1731",
            "fax_number": "949-721-9194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 SAN MIGUEL DR",
            "address_2": "SUITE 206",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607812",
            "telephone_number": "949-729-1731",
            "fax_number": "949-721-9194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIFREN",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "G75154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Joseph Sheptock, DPT
• Carol Shi, M.D
• Jonathan Mou Jun Shiau, M.D.
• Shima Shiehzadegan, FNP-C
• Mona Ahmad Shiekh Sroujieh, MD
• Shift: a Psychological Corporation
• Sandra Shigetomi-Toyama
• Natasha Ly Shih, PHARMD, MPH
• Matthew I Shihab
• Tiffany Shimizu

• Plastic and Reconstructive Surgery Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Plastic and Reconstructive Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.