Tae M Shin, M.D. Inc.

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

G85170 Issued in CA

Legal business name

TAE M SHIN, M.D. INC.

Practice address

4220 W 3Rd St
Suite #208
Los Angeles, CA 90020-3450

Phone

(213) 386-3554

Fax

(805) 991-4065

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Miss Rose Marie Rivera

Title

Director of Billing Operations

Phone

(805) 577-8730

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joon Y Koh, MD

  • Orthopaedic Surgery Physician
  • Los Angeles, CA
  • NPI 1205927266
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922139757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 65",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930620065",
            "telephone_number": "805-577-8730",
            "fax_number": "805-991-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 W 3RD ST",
            "address_2": "SUITE #208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203450",
            "telephone_number": "213-386-3554",
            "fax_number": "805-991-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAE M SHIN, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "ROSE MARIE",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING OPERATIONS",
        "authorized_official_telephone_number": "805-577-8730",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "G85170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G851700",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aynalem Tadesse
• Bryce Tadokoro
• Farid Karim Tadros
• Reda Michael Tadros, M.D.
• Christina Tanios Tadrous, M.D.
• Tae Sung & Brothers
• Jenny S Tae
• Thomas Tae I, ARNP
• Tanya Taefi, PHARM.D.
• Bernard Isaac Taesali

• Orthopaedic Surgery of the Spine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Orthopaedic Surgery of the Spine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.