Individual provider Active NPI

Michelle Shin, OD

  • Optometrist
  • Hermosa Beach, CA
National Provider Identifier
1376039602
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT33924TLG Issued in CA
Practice address
1200 Artesia Blvd Ste 100
Hermosa Beach, CA 90254-2755
Phone
(310) 933-5035
Fax
(888) 302-8335
NPI assigned
Jul 10, 2018
Last updated
Jan 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT33924TLG CA Primary

Addresses

Primary practice location

1200 Artesia Blvd Ste 100
Hermosa Beach, CA 90254-2755

Mailing address

1200 Artesia Blvd Ste 100
Hermosa Beach, CA 90254-2755
Phone (310) 933-5035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181005001245 CA Practitioner - Optometry 3072865880 Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33924CAMDChiropractor
OPT33924TLGCAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eileen J. Bell Optometrist CurrentSince May 1, 2020 Accepting new patients
Gerry Gee, Optometry Optometrist PastSince Mar 28, 2021 Accepting new patients
Yuan Optometry, a Professional Corporation PastSince Jul 17, 2021 Accepting new patients

Locations

302 W Grand Ave
Ste 1
El Segundo, CA 90245
Phone (310) 414-9595

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768262400000",
    "number": "1376039602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 ARTESIA BLVD STE 100",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542755",
            "telephone_number": "310-933-5035",
            "fax_number": "888-302-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 ARTESIA BLVD STE 100",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542755",
            "telephone_number": "310-933-5035",
            "fax_number": "888-302-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT33924TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermosa Beach, CA

Sources for this page

Verify at the official NPI Registry.