Dong Joo Shin

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC19455 Issued in CA

Practice address

9884 Garden Grove Blvd
Garden Grove, CA 92844-1643

Phone

(714) 822-7330

NPI assigned

Aug 23, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1013636190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10560 LAKESIDE DR N UNIT D",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928405058",
            "telephone_number": "949-331-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9884 GARDEN GROVE BLVD",
            "city": "GARDEN GROVE",
            "state": "CA",
            "postal_code": "928441643",
            "telephone_number": "714-822-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "DONG JOO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC19455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shield Medical Management Services LLC
• Paul Shim
• Eriko Shimojo
• Christina Shin, OTD, OTR/L, CLT-LANA
• David Shin
• Jieun Shin
• John Sanghyun Shin, DISPENSER
• Kevin Y Shin, DC
• Marie Wonkyong Shin, DPM
• Sang Yun Shin, L.AC.

• Acupuncturist in Garden Grove, CA
• Providers in Garden Grove, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.