Provider Demographics
NPI:1790759066
Name:SHAIN, TIN ZAR (MD)
Entity Type:Individual
Prefix:DR
First Name:TIN
Middle Name:ZAR
Last Name:SHAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:TIN
Other - Middle Name:ZAR
Other - Last Name:SHAIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:10633 GRISSOM AVENUE
Mailing Address - Street 2:
Mailing Address - City:MATHER
Mailing Address - State:CA
Mailing Address - Zip Code:95655
Mailing Address - Country:US
Mailing Address - Phone:916-366-5420
Mailing Address - Fax:916-366-5441
Practice Address - Street 1:10633 GRISSOM AVENUE
Practice Address - Street 2:
Practice Address - City:MATHER
Practice Address - State:CA
Practice Address - Zip Code:95655
Practice Address - Country:US
Practice Address - Phone:916-366-5420
Practice Address - Fax:916-366-5441
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA622662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry