Healthcare Provider Details

I. General information

NPI: 1033670898
Provider Name (Legal Business Name): CHRISTOPHER SHIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11600 W 2ND PL
LAKEWOOD CO
80228-1527
US

IV. Provider business mailing address

7375 W 52ND AVE STE 210
ARVADA CO
80002-3748
US

V. Phone/Fax

Practice location:
  • Phone: 720-321-0000
  • Fax:
Mailing address:
  • Phone: 303-223-4448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberDR.0074776
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number1019848
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: