Shin, John C

Shin, John C is an individual health care provider with primary practice located at 901 E St Ste 285, San Rafael CA 94901-2850. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Shin, John C can be contacted via phone (415) 454-5565.

Contact Information

Primary practice address
901 E St Ste 285 San Rafael CA 94901-2850
Phone: (415) 454-5565
Fax: (415) 454-2957
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X G77943 California

Profile Details

NPI number 1114920477
LBN Legal business name Shin, John C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2005
Last updated Jul 16th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114920477 NPPES
California MEDICAID GR0015750

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