Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | A60900 | CA |
Y | 2081P2900X | Pain Medicine | A60900 | CA |
NPI | 1255473575 |
---|---|
Provider Name | Dr. Carl Hyun-Geol Shin |
First Address | Sacramento, CA 95825-2482 |
Second Address | Sacramento, CA 95825-2482 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 15/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G64120 | (02) | CA |