Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 170100000X | Medical Geneticist | A61649 | CA |
NPI | 1326060179 |
---|---|
Provider Name | Mr. Chris C Shin |
First Address | La Palma, CA 90623-1731 |
Second Address | La Palma, CA 90623-1731 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A616490 | (05) | CA |