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General NPI Number Information
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NPI Number | 1730486333
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Entity Type | Organization
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Legal Business Name | SUN J SHIN MD INC
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Dates
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Enumeration Date | 02/16/2011
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Last Update Date | 02/16/2011
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Provider Practice Location Address
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Address Line | 866 S WESTMORELAND AVE STE 101
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City | LOS ANGELES
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State | CA
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Zip | 90005-1502
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Country | US
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Telephone | 213-380-2266
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Fax | 213-380-3514
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Provider Business Mailing Address
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Address Line | 866 S WESTMORELAND AVE STE 101
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City | LOS ANGELES
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State | CA
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Zip | 90005-1502
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Country | US
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Telephone | 213-380-2266
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Fax | 213-380-3514
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUN J SHIN
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Credential | MD
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Telephone | 213-380-2266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | A37352
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License Number State | CA
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