Grace Family Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A49058 Issued in CA

Legal business name

GRACE FAMILY MEDICAL GROUP

Practice address

2100 S Euclid St
Suite 101
Anaheim, CA 92802

Phone

(714) 638-1347

Fax

(714) 534-2098

NPI assigned

May 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. James S Shin, MDNPI 1619902624

Title

President

Phone

(714) 638-1347

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• James S Shin, MD

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1619902624
  NPD (past) Authorized official

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265489850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 S EUCLID ST",
            "address_2": "SUITE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92802",
            "telephone_number": "714-638-1347",
            "fax_number": "714-534-2098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 S EUCLID ST",
            "address_2": "SUITE 101",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "92802",
            "telephone_number": "714-638-1347",
            "fax_number": "714-534-2098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE FAMILY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-638-1347",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A49058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ29510Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0251124",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seema Goyal, MD
• Magnolia Panganiban Gozun, OTR
• GP Anaheim Ivf, PC
• GPS Hospice Care Inc.
• Grace Family Medical Center, Inc.
• Grace H Jeon M D M P H F a C S a Professional Corporation
• Grace Young, M.D., Inc.
• Cole Thomas Grace
• Graceful Care Home Health Services Inc.
• Graceful Day Personal Home Care

• Family Medicine Physician in Anaheim, CA
• Providers in Anaheim, 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 Aug 22, 2020; 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.