Individual
TAE MIN SHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1245 WILSHIRE BLVD., SUITE 400, LOS ANGELES, CA 90017
(213) 482-2992
(213) 482-2999
Mailing address
1245 WILSHIRE BLVD STE 400, LOS ANGELES, CA 90017-4810
(213) 482-2992
(213) 482-2999
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
G85170
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G851700
—
CA
Enumeration date
09/01/2006
Last updated
04/16/2012
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