MEDICARE: DR. YOUNG SHIN PHARMD

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	68233	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	68233	OTHER	CA	CALIFORNIA PHARMACY LICENSE

General Provider Information

NPI Number	:	1497148498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YOUNG SHIN PHARMD

Provider Business Mailing Address
First Line	:	1020 UNIVERSITY AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-7325
Country	:	US
Telephone Number	:	619-298-5181
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 UNIVERSITY AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-7325
Country	:	US
Telephone Number	:	619-298-5181
Fax Number	:

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

Provider Enumeration Date	:	03/15/2015
Last Update Date	:	03/15/2015

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