Provider Demographics
NPI:1437444601
Name:SHIN, HYUN
Entity Type:Individual
Prefix:
First Name:HYUN
Middle Name:
Last Name:SHIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3855 W 7TH ST
Mailing Address - Street 2:APT 301
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-5101
Mailing Address - Country:US
Mailing Address - Phone:213-507-1808
Mailing Address - Fax:
Practice Address - Street 1:3855 W 7TH ST
Practice Address - Street 2:APT 301
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-5101
Practice Address - Country:US
Practice Address - Phone:213-507-1808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 11766171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist