Provider Demographics
NPI:1487611372
Name:SHAHINIAN, GEORGE KEVORK (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:KEVORK
Last Name:SHAHINIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25467 NELLIE GAIL RD
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-6306
Mailing Address - Country:US
Mailing Address - Phone:949-521-6060
Mailing Address - Fax:949-521-6063
Practice Address - Street 1:11 MAREBLU STE 200
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-3044
Practice Address - Country:US
Practice Address - Phone:949-521-6060
Practice Address - Fax:949-521-6063
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63870207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A638700Medicaid
CAWA63870AMedicare ID - Type Unspecified
CA00A638700Medicaid