Active NPI
Lisa Suhyun Shin
- Pharmacist
- San Jose, CA
National Provider Identifier
1659982601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 82916
- Practice address
- 5146 Stevens Creek Blvd
San Jose, CA 95129-1019 - Phone
- (408) 556-0614
- NPI assigned
- Aug 13, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 82916 | CA | Primary |
Addresses
Primary practice location
5146 Stevens Creek Blvd
San Jose, CA 95129-1019
Mailing address
1146 Kelez Dr
San Jose, CA 95120-2858
Phone (408) 506-7339
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 82916 | CA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Retail Pharmacy
- San Jose, CA
- NPI 1043256670
-
- Community/Retail Pharmacy
- Queen Creek, AZ
- NPI 1730040973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614729600000",
"number": "1659982601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1146 KELEZ DR",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951202858",
"telephone_number": "408-506-7339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5146 STEVENS CREEK BLVD",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951291019",
"telephone_number": "408-556-0614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "LISA",
"middle_name": "SUHYUN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-13",
"last_updated": "2021-03-03",
"certification_date": "2021-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "82916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.