Active NPI
Shin MRI LLC
- Radiology Clinic/Center
- Los Angeles, CA
National Provider Identifier
1295841377
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiology Clinic/Center
- License
- NA
- Legal business name
- SHIN MRI LLC
- Practice address
- 266 S Harvard Blvd Ste 220
Los Angeles, CA 90004-4339 - Phone
- (213) 387-3002
- NPI assigned
- Aug 22, 2006
- Last updated
- Feb 3, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Kyungja Shin Elkjer
- Title
- Ceo
- Phone
- (213) 387-3002
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Clinic/Center | 261QR0200X | NA | Primary |
Addresses
Primary practice location
266 S Harvard Blvd Ste 220
Los Angeles, CA 90004-4339
Mailing address
266 S Harvard Blvd Ste 220
Los Angeles, CA 90004-4339
Phone (213) 387-3002
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040427000643 | CA | Part B Supplier - Independent Diagnostic Testing Facility (Idtf) | 3870580491 | Practice locations: Los Angeles, CA |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Providence St. Jude Medical Center
- Rehabilitation Hospital
- Fullerton, CA
- NPI 1942404165
Member Of
Practitioners & affiliated clinicians
Practitioners 38
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1328227200000",
"number": "1295841377",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "266 S HARVARD BLVD STE 220",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900044339",
"telephone_number": "213-387-3002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "266 S HARVARD BLVD STE 220",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900044339",
"telephone_number": "213-387-3002"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHIN MRI LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-22",
"last_updated": "2012-02-03",
"status": "A",
"authorized_official_last_name": "ELKJER",
"authorized_official_first_name": "KYUNGJA",
"authorized_official_middle_name": "SHIN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "213-387-3002",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "261QR0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Radiology",
"state": null,
"license": "NA",
"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 3, 2012; 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.