Provider Demographics
NPI:1861586554
Name:O'CONNOR, SHANNON MICHELE (MD)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:MICHELE
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5 JOURNEY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-5330
Mailing Address - Country:US
Mailing Address - Phone:949-360-1069
Mailing Address - Fax:949-389-8968
Practice Address - Street 1:5 JOURNEY
Practice Address - Street 2:SUITE 130
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-5330
Practice Address - Country:US
Practice Address - Phone:949-360-1069
Practice Address - Fax:949-389-8968
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2022-11-29
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Provider Licenses
StateLicense IDTaxonomies
CAA90415207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine