Bora Shin, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A147055 Issued in CA

Practice address

7212 Orangethorpe Ave Ste 9a
Buena Park, CA 90621-4668

Phone

(714) 503-6550

NPI assigned

Jun 25, 2014

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: bora.shin.p1@direct.kcs.nextgenshare.com

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.

• Marque Medical Clinic, Inc.

  dba Marque Urgent Care, Inc.-Newport Beach

  • Urgent Care Clinic/Center
  • Newport Beach, CA
  • NPI 1538466107
  Medicare reassignment NPD
• Marque Medical Clinic, Inc

  • Urgent Care Clinic/Center
  • Chula Vista, CA
  • NPI 1164303442
  NPD
• New Light Medical Group, Inc.

  • Health Maintenance Organization
  • Anaheim, CA
  • NPI 1912133364
  NPD (past)
• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  NPD (past)

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1912312117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7212 ORANGETHORPE AVE STE 9A",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906214668",
            "telephone_number": "714-503-6550",
            "fax_number": "714-409-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7212 ORANGETHORPE AVE STE 9A",
            "city": "BUENA PARK",
            "state": "CA",
            "postal_code": "906214668",
            "telephone_number": "714-503-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "BORA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "7009",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A147055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyuyoung Shim
• Lynn Jang Shim
• James Shimoda, OTR/L
• Shin Imaging LLC (Shin Imaging Center)
• Ashley Jeesoo Shin
• Hey-Keun Shin
• Hyewon Shin
• Soomin Sarah Shin, PT
• Roman Carlo Silvestre, PTA
• Sim C Hoffman (Advanced Professional Imaging Medical Group)

• Pediatrics Physician in Buena Park, CA
• Providers in Buena Park, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.