Edward C. Shin, M.D Inc

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

A108147 Issued in CA

Legal business name

EDWARD C. SHIN, M.D INC

Practice address

1838 El Camino Real Ste 100
Burlingame, CA 94010-3105

Phone

(415) 346-1114

Fax

(415) 634-0206

NPI assigned

May 21, 2013

Organization subpart

No

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

Authorized official

Name

Edward C. Shin, M.DNPI 1720245186

Title

Ceo

Phone

(415) 346-1114

Specialties & licenses 1

Addresses

Other names 1

• Burlingame Orthopedics and Sports Medicine Associates Inc Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Edward C Shin, M.D.

  • Orthopaedic Surgery Physician
  • Burlingame, CA
  • NPI 1720245186
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1369094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722816000000",
    "number": "1205272853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1838 EL CAMINO REAL STE 100",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103105",
            "telephone_number": "415-346-1114",
            "fax_number": "415-634-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1838 EL CAMINO REAL STE 100",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103105",
            "telephone_number": "415-346-1114",
            "fax_number": "415-634-0206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2299 Post St Ste 107",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941153460",
            "country_code": "US",
            "telephone_number": "415-346-1114",
            "fax_number": "415-634-0206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EDWARD C. SHIN, M.D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-21",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-346-1114",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "A108147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burlingame Orthopedics and Sports Medicine Associates Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Sports Medicine (Orthopaedic Surgery) Physician in Burlingame, CA
• Providers in Burlingame, CA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.