Active NPI
John Shin, PHARMD
- Pharmacist
- Los Angeles, CA
National Provider Identifier
1235720350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 69749
- Practice address
- 1500 San Pablo St
Los Angeles, CA 90033-5313 - Phone
- (323) 442-8394
- NPI assigned
- Feb 1, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 69749 | CA | Primary |
Addresses
Primary practice location
1500 San Pablo St
Los Angeles, CA 90033-5313
Mailing address
2077 Hanscom Dr
South Pasadena, CA 91030-4011
Phone (213) 268-3454
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69749 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612137600000",
"number": "1235720350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2077 HANSCOM DR",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "910304011",
"telephone_number": "213-268-3454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 SAN PABLO ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900335313",
"telephone_number": "323-442-8394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-02-01",
"last_updated": "2021-02-01",
"certification_date": "2021-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "69749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.