Humbled One Nursing Group Corp

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

HUMBLED ONE NURSING GROUP CORP

Doing business as

Primary Care and IV

Practice address

5471 La Palma Ave Ste 105
La Palma, CA 90623-1773

Phone

(714) 695-2388

Fax

(714) 695-2391

NPI assigned

May 2, 2024

Organization subpart

No

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

Authorized official

Name

Namju Kim Shin, AGNP-CNPI 1326377292

Title

Ceo

Phone

(714) 695-2388

Specialties & licenses 1

Addresses

Other names 1

• PRIMARY CARE AND IV Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Namju Kim Shin, AGNP-C

  • Adult Health Nurse Practitioner
  • La Palma, CA
  • NPI 1326377292
  Medicare reassignment NPD Authorized official
• Dipankar Ghosh, DO

  • Internal Medicine Physician
  • Oakland, CA
  • NPI 1508020009
  Medicare reassignment NPD

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

{
    "created_epoch": "1714608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734134400000",
    "number": "1073360467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5471 LA PALMA AVE STE 105",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231773",
            "telephone_number": "714-695-2388",
            "fax_number": "714-695-2391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5471 LA PALMA AVE STE 105",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231773",
            "telephone_number": "714-695-2388",
            "fax_number": "714-695-2391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMBLED ONE NURSING GROUP CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-12-14",
        "certification_date": "2024-12-14",
        "status": "A",
        "authorized_official_last_name": "KIM SHIN",
        "authorized_official_first_name": "NAMJU",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-695-2388",
        "authorized_official_credential": "AGNP-C"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIMARY CARE AND IV",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PRIMARY CARE AND IV",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hope Fertility & Gynecology
• Shelly Shunju Hsieh, NP, PA
• Jessica Hu
• Grace Huang, RDN
• Zhiqi Huang
• Amanda Hunter, MS
• Henry H Huynh, RCP, RRT
• Sarah N. Hwang, M.D.
• Hyunju Lee MD a Professional Corporation
• Ana Marcela Idelfonzo

• Primary Care Nurse Practitioner in La Palma, CA
• Providers in La Palma, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.