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Organization
GRACE FAMILY MEDICAL GROUP
Active
Organization
GRACE FAMILY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES S SHIN MD (PRESIDENT)
(714) 638-1347
Entity
Organization
Contact information
Practice address
2100 S EUCLID ST, SUITE 101, ANAHEIM, CA 92802
(714) 638-1347
(714) 534-2098
Mailing address
2100 S EUCLID ST, SUITE 101, ANAHEIM, CA 92802
(714) 638-1347
(714) 534-2098
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A49058
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0251124
—
CA
01
—
ZZZ29510Z
BLUE SHIELD
—
Enumeration date
05/28/2006
Last updated
08/22/2020
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