Manohar Sambhaji Shinde, MD PHD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A 34597 Issued in CA

Practice address

6425 San Fernando Road
Glendale, CA 91201-3624

Phone

(818) 956-0101

Fax

(818) 956-1413

NPI assigned

Sep 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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.

• Eating Disorder Institute of California

  • Psychiatry Physician
  • Glendale, CA
  • NPI 1922319441
  NPD (past) Authorized official

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659472124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6425 SAN FERNANDO ROAD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912013624",
            "telephone_number": "818-956-0101",
            "fax_number": "818-956-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 SAN FERNANDO ROAD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912013624",
            "telephone_number": "818-956-0101",
            "fax_number": "818-956-1413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINDE",
        "first_name": "MANOHAR",
        "middle_name": "SAMBHAJI",
        "name_prefix": "Mr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A 34597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7997816",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shin Acupuncture and Herbs, Inc.
• Shin Acupuncture and Herbs, Inc.
• Dong Kil Shin, L.AC.
• Jenny Jeongwon Shin, PHARMD
• Peter E Shin, M.D.
• Shine Hospice and Palliative Care
• Shine MMG Inc
• Kathy Shinozaki, P.A.
• Mariah Shipp
• Mehrnoosh Shirazi

• Psychiatry Physician in Glendale, CA
• Providers in Glendale, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.