Min Soo Shin MD, Apc

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

A40822 Issued in CA

Legal business name

MIN SOO SHIN MD, APC

Practice address

2968 E Florence Ave
Huntington Park, CA 90255

Phone

(323) 583-1500

Fax

(323) 583-1661

NPI assigned

Jun 28, 2011

Last updated

Jul 18, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Min Soo Shin, M.DNPI 1720005259

Title

Physician

Phone

(323) 583-1500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Santa Catalina Medical Clinic Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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.

• Min Soo Shin, MD,APC

  • Cardiovascular Disease Physician
  • Huntington Park, CA
  • NPI 1720005259
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310947200000",
    "number": "1235425273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2968 E FLORENCE AVE",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "902555826",
            "telephone_number": "323-583-1500",
            "fax_number": "323-583-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2968 E FLORENCE AVE",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "90255",
            "telephone_number": "323-583-1500",
            "fax_number": "323-583-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIN SOO SHIN MD, APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-28",
        "last_updated": "2011-07-18",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "MIN",
        "authorized_official_middle_name": "SOO",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "323-583-1500",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A40822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A408220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Santa Catalina Medical Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Cardiovascular Disease Physician in Huntington Park, CA
• Providers in Huntington Park, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2011; 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.