Organization
CENTER FOR INTERVENTIONAL SPINE, A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL HYUN-GEOL SHIN (MEDICAL DIRECTOR)
(916) 977-0741
Entity
Organization
Contact information
Practice address
2424 ARDEN WAY STE 301, SACRAMENTO, CA 95825-2464
(916) 977-0741
(916) 977-0547
Mailing address
2424 ARDEN WAY STE 301, SACRAMENTO, CA 95825-2464
(916) 977-0741
(916) 977-0547
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
A60900
CA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
CA
208VP0014X
Interventional Pain Medicine Physician
A60900
CA
208VP0014X
Interventional Pain Medicine Physician
Primary
—
CA
332900000X
Non-Pharmacy Dispensing Site
A60900
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255473575
CARL SHIN NPI
CA
01
—
5628017
NCPDP
CA
01
—
G64120
CARL SHIN UPIN
CA
Enumeration date
04/12/2007
Last updated
03/31/2023
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