Ellen Shin

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A180492 Issued in CA

Practice address

10750 4TH St BLDG 1
Rancho Cucamonga, CA 91730-0979

Phone

(909) 481-1332

NPI assigned

Mar 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Whole Person Care PLLC

  • Physical Medicine & Rehabilitation Physician
  • Lynnwood, WA
  • NPI 1295523082
  NPD

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1588123798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10750 4TH ST BLDG 1",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300979",
            "telephone_number": "909-481-1332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10750 4TH ST BLDG 1",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300979",
            "telephone_number": "909-481-1332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A180492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judi H Shiba, OTR,L
• Andrea L. Shields, PH.D.
• Anthony David Shields, IMFT
• Shandreika Shields
• Karen Shigenaka
• Chris Shitabata, DDS
• Mark L Shiu, DO
• Brandi Shoemaker
• Hannah Shorr
• Irina Shostak

• Family Medicine Physician in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, 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 Sep 5, 2023; 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.