Individual provider Active NPI

Daniel Hyun Jin, M.D.

  • Vascular & Interventional Radiology Physician
  • Loma Linda, CA
National Provider Identifier
1659697654
Registry record updated Nov 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
A120252 Issued in CA
Practice address
11234 Anderson Street
Graduate Medical Education Office CP 21005
Loma Linda, CA 92354-2804
Phone
(909) 558-0430
NPI assigned
Apr 15, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A120252 CA
Vascular & Interventional Radiology Physician 2085R0204X A120252 CA Primary

Addresses

Primary practice location

11234 Anderson Street
Graduate Medical Education Office CP 21005
Loma Linda, CA 92354-2804

Mailing address

11234 Anderson Street
Graduate Medical Education Office CP 21005
Loma Linda, CA 92354-2804
Phone (909) 558-0430

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161018001744 CA Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 5092003467 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Loma Linda University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Riverside, CA 92501
Phone (951) 788-3400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A120252CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Medical Group, Inc Family Medicine CurrentSince Oct 20, 2018 Accepting new patients
Pinnacle Medical Group, Inc Family Medicine CurrentSince Oct 20, 2018 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Beaumont Radiology Services LLC CurrentSince Jun 1, 2017 Accepting new patients
Faculty Physicians and Surgeons of Llusm Family Medicine CurrentSince Jul 1, 2017 Accepting new patients
Faculty Physicians and Surgeons of Llusm Family Medicine CurrentSince Jul 1, 2017 Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Universal Radiology Consultants PC Diagnostic Radiology PastSince Aug 12, 2017 Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients

Locations

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

25455 Barton Rd
Loma Linda, CA 92354
Phone (909) 558-2808

11234 Anderson St
Ofc Cp
Loma Linda, CA 92350
Phone 9095584000 ext. 88131

11234 Anderson St
Loma Linda, CA 92350
Phone (909) 558-3016

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

10431 Lemon Ave
Ste N
Rch Cucamonga, CA 91737
Phone (909) 466-6579

1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

3762 Tibbetts St
Riverside, CA 92506
Phone (951) 686-2224

Organizations & group practices 10

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700265600000",
    "number": "1659697654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON STREET",
            "address_2": "GRADUATE MEDICAL EDUCATION OFFICE CP 21005",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11234 ANDERSON STREET",
            "address_2": "GRADUATE MEDICAL EDUCATION OFFICE CP 21005",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542804",
            "telephone_number": "909-558-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIN",
        "first_name": "DANIEL",
        "middle_name": "HYUN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-15",
        "last_updated": "2023-11-18",
        "certification_date": "2023-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A120252",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": "A120252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.