Yeyongshin DO Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

YEYONGSHIN DO INC

Practice address

1111 Grand Ave Ste J
Diamond Bar, CA 91765-4172

Phone

(909) 306-4102

NPI assigned

Jul 9, 2021

Organization subpart

No

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

Authorized official

Name

Yeyong ShinNPI 1679831028

Title

Owner

Phone

(909) 306-4102

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yeyong Shin, DO

  • Family Medicine Physician
  • Montclair, CA
  • NPI 1679831028
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625788800000",
    "number": "1215508247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 GRAND AVE STE J",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654172",
            "telephone_number": "909-306-4102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 GRAND AVE STE J",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917654172",
            "telephone_number": "909-306-4102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YEYONGSHIN DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-09",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "YEYONG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-306-4102"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eliza Hisako Yamamoto, OTR/L
• Lynn F. Y. Yamamoto, M.S., M.F.T.
• Jenchen Yang, M.D., PH.D
• Peter Soler Yatar Jr., M.D.
• Alice Yi Yeh, RN
• Justin Harrison Yim
• Li Yin
• Bonnie Yoo, LCSW
• Hana Yoo
• Kay Kyunghwa Yoo, D.D.S.

• Family Medicine Physician in Diamond Bar, CA
• Providers in Diamond Bar, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.