MEDICARE: DR. YOON SUP SHIN M.D.

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	207R00000X	Internal Medicine Physician	A85523	CA
2	208000000X	Pediatrics Physician	A85523	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	A85523	OTHER	CA	LICENSE

General Provider Information

NPI Number	:	1629071451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YOON SUP SHIN M.D.

Provider Business Mailing Address
First Line	:	2017 W OLYMPIC BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-3705
Country	:	US
Telephone Number	:	213-480-1000
Fax Number	:	213-401-0018

Provider Business Practice Location Address
First Line	:	2017 W OLYMPIC BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-3705
Country	:	US
Telephone Number	:	213-480-1000
Fax Number	:	213-401-0018

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	09/11/2025

Similar Medicare Providers

1073588927 — DR. SANG H YOON D.C.
Practice Location Address:

2017 W OLYMPIC BLVD
LOS ANGELES, CA
90006-3705

Practice Phone: 213-480-1000
Practice Fax:

1861575680 — HANA OB/GYN MEDICAL GROUP INC.
Practice Location Address:

2017 W OLYMPIC BLVD
LOS ANGELES, CA
90006-3705

Practice Phone: 213-381-6001
Practice Fax: 213-381-6013

1245351808 — BEACON COMMUNITY MEDICAL CENTER, INC.
Practice Location Address:

2017 W OLYMPIC BLVD
LOS ANGELES, CA
90006-3705

Practice Phone: 213-480-1000
Practice Fax: 213-401-0018

1245452564 — HANMAEUM SENIOR SERVICES, INC.
Practice Location Address:

2001 W. OLYMPIC BLVD
LOS ANGELES, CA
90006-3705

Practice Phone: 213-736-0001
Practice Fax: 213-736-6581

1619158839 — SALIDA DEL SOL ADHC, LLC
Practice Location Address:

2001 W OLYMPIC BLVD
LOS ANGELES, CA
90006-3705

Practice Phone: 213-736-9450
Practice Fax: 212-736-9457

1306705504 — EMILY FORCHE
Practice Location Address:

1948 RIVERSIDE DR
LOS ANGELES, CA
90039-3705

Practice Phone: 913-271-0844
Practice Fax:

Directions to “ DR. YOON SUP SHIN M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.