NPI 1144685447

Shannon Wongvibulsin

Practitioner Dermatology Physician Orange, CA

Practice location

Address: 101 the City Dr S, Orange, CA 92868-3201
Phone: (714) 456-8888
Mailing address: 733 Rutland Ave., Baltimore, MD 21205-2109

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence A181956 (CA)

Other Dermatology providers in California →

Registry record

NPI: 1144685447
Entity type: Individual
Sex (as registered): Female
NPI issued: 31 Dec 2015
Record last updated: 1 Jul 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.