NPIMap

Organization Active NPI

Shin MRI LLC

  • Radiology Clinic/Center
  • Los Angeles, CA
National Provider Identifier
1295841377
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
O20040427000643 CA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3870580491 Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

266 S Harvard Blvd
Ste 180
Los Angeles, CA 90004
Phone (213) 387-3002

Practitioners & affiliated clinicians

Practitioners 37

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

View all 37

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.

Verify at the official NPI Registry.