Provider Demographics
NPI:1235150467
Name:TRANSFIGURACION SHIN, CHRISTIANNE J
Entity Type:Individual
Prefix:
First Name:CHRISTIANNE
Middle Name:J
Last Name:TRANSFIGURACION SHIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24640 JEFFERSON AVE STE 109
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-9027
Mailing Address - Country:US
Mailing Address - Phone:951-677-1323
Mailing Address - Fax:951-239-4233
Practice Address - Street 1:24640 JEFFERSON AVE STE 109
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-9027
Practice Address - Country:US
Practice Address - Phone:951-677-1323
Practice Address - Fax:951-239-4233
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4573213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E45730Medicaid
CA5598910001Medicare NSC
CA000E45730Medicaid
CAWE4573AMedicare PIN