Provider Demographics
NPI:1467533026
Name:SHI, MIN (LAC, PHD)
Entity Type:Individual
Prefix:MR
First Name:MIN
Middle Name:
Last Name:SHI
Suffix:
Gender:M
Credentials:LAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 ENDEAVOR STE 301
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3177
Mailing Address - Country:US
Mailing Address - Phone:949-727-0898
Mailing Address - Fax:
Practice Address - Street 1:18 ENDEAVOR STE 301
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3177
Practice Address - Country:US
Practice Address - Phone:949-727-0898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7089171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist