Mark D Gaon MD Inc

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

A87237 Issued in CA

Legal business name

MARK D GAON MD INC

Practice address

1501 Superior Ave Ste 300
Newport Beach, CA 92663-3641

Phone

(949) 642-3420

Fax

(951) 599-4664

NPI assigned

Jun 7, 2018

Organization subpart

No

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

Authorized official

Name

Elsa Munguia

Title

Biller

Phone

(951) 335-5461

Specialties & licenses 1

Addresses

Other names 1

• MARK D GAON MD Doing business as

Locations

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1447743182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10694 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925051816",
            "telephone_number": "951-335-5461",
            "fax_number": "951-335-5468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 SUPERIOR AVE STE 300",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633641",
            "telephone_number": "949-642-3420",
            "fax_number": "951-599-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK D GAON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-07",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "MUNGUIA",
        "authorized_official_first_name": "ELSA",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "951-335-5461"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "A87237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARK D GAON MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• 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 Feb 23, 2023; 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.