Individual
DR. ANTHONY S SHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12000 MOUNT VERNON AVE, GRAND TERRACE, CA 92313-5174
(951) 273-0136
(951) 848-9121
Mailing address
PO BOX 946, LOMA LINDA, CA 92354-0946
(951) 273-0136
(951) 848-9121
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A42601
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A426010
—
CA
Enumeration date
07/26/2006
Last updated
05/07/2020
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