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NPI Code Detail

MEDICARE: MICHAEL SHIM M.D.

MEDICARE: MICHAEL SHIM 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
1207RG0100XGastroenterology PhysicianA88942CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851503353
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL SHIM M.D.
Provider Business Mailing Address
First Line : 3923 WARING RD STE A
Second Line :
City : OCEANSIDE
State : CA
Zip : 92056-4499
Country : US
Telephone Number : 760-724-8782
Fax Number : 760-842-7801
Provider Business Practice Location Address
First Line : 3923 WARING RD STE A
Second Line :
City : OCEANSIDE
State : CA
Zip : 92056-4499
Country : US
Telephone Number : 760-724-8782
Fax Number : 760-842-7801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2007
Last Update Date : 02/25/2021

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