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NPI Code Detail

MEDICARE: SEAN JONGJIN JIN MD

MEDICARE: SEAN JONGJIN JIN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician0101283318VA

General Provider Information

NPI Number : 1033814744
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN JONGJIN JIN MD
Provider Business Mailing Address
First Line : 3551 ROGER BROOKE DR
Second Line :
City : FORT SAM HOUSTON
State : TX
Zip : 78234-4504
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3551 ROGER BROOKE DR
Second Line :
City : FORT SAM HOUSTON
State : TX
Zip : 78234-4504
Country : US
Telephone Number : 310-892-5500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2023
Last Update Date : 06/15/2026

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Directions to “ SEAN JONGJIN JIN MD” Practice Location

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