Dongsoo Shin, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A37182 Issued in CA

Practice address

15651 Imperial Hwy
Suite 205
La Mirada, CA 90638-1628

Phone

(562) 943-4747

Fax

(888) 552-6469

NPI assigned

Nov 10, 2006

Sex

Male

Sole proprietor

Yes

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

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1811068190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15651 IMPERIAL HWY",
            "address_2": "SUITE 205",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381128",
            "telephone_number": "562-943-4747",
            "fax_number": "888-552-6469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15651 IMPERIAL HWY",
            "address_2": "SUITE 205",
            "city": "LA MIRADA",
            "state": "CA",
            "postal_code": "906381628",
            "telephone_number": "562-943-4747",
            "fax_number": "888-552-6469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "DONGSOO",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A37182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A371820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ajit Chunilal Shah, M.D.
• Elisa Shepard, PH.D.
• Shepherd'S Hope Home Health Services, Inc.
• Lyncie Elizabeth Raju Shiau, NP
• Shield Transportation Services
• Kwangsun Chun Shin
• Mihye Shin
• Brittany Shoffeitt, FNP
• Kayleigh Shults
• Diana Estefania Sicairos

• Family Medicine Physician in La Mirada, CA
• Providers in La Mirada, 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 May 30, 2012; 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.