Kwangsun Chun Shin

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY46563 Issued in CA

Practice address

15074 Imperial Hwy
La Mirada, CA 90638-1301

Phone

(562) 902-5580

Fax

(562) 902-5589

NPI assigned

Mar 18, 2019

Sex

Female

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kwangsun C Shin

  • Community/Retail Pharmacy
  • La Mirada, CA
  • NPI 1316044159
  NPD Authorized official

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1093274128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15074 IMPERIAL HWY",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381301",
            "telephone_number": "562-902-5580",
            "fax_number": "562-902-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15074 IMPERIAL HWY",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381301",
            "telephone_number": "562-902-5580",
            "fax_number": "562-902-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "KWANGSUN",
        "middle_name": "CHUN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY46563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisa Shepard, PH.D.
• Shepherd'S Hope Home Health Services, Inc.
• Lyncie Elizabeth Raju Shiau, NP
• Shield Transportation Services
• Dongsoo Shin, M.D
• Mihye Shin
• Brittany Shoffeitt, FNP
• Kayleigh Shults
• Diana Estefania Sicairos
• Shareef Siddiqui

• Community/Retail Pharmacy in La Mirada, CA
• Providers in La Mirada, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; 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.