Provider Demographics
NPI:1821516188
Name:SHIN, HYUN C (LAC)
Entity Type:Individual
Prefix:
First Name:HYUN
Middle Name:C
Last Name:SHIN
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 S KENMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-1507
Mailing Address - Country:US
Mailing Address - Phone:323-605-2846
Mailing Address - Fax:888-572-2038
Practice Address - Street 1:3053 W OLYMPIC BLVD STE 308
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2558
Practice Address - Country:US
Practice Address - Phone:323-605-2846
Practice Address - Fax:888-572-2038
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-06
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist