MEDICARE: ANGELA SHIN

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
1	183500000X	Pharmacist	88643	CA

General Provider Information

NPI Number	:	1093661944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA SHIN

Provider Business Mailing Address
First Line	:	3545 WILSHIRE BLVD APT 1527
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-4318
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6076 BRISTOL PKWY STE 104
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90230-6600
Country	:	US
Telephone Number	:	310-645-1500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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Directions to “ ANGELA SHIN ” Practice Location

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