| Peter B. Shin,m.d.,inc | |
|
3440 Lomita Blvd 427 Torrance CA 90505-4801 | |
| (310) 326-2161 | |
| (310) 534-5026 |
| Full Name | Peter B. Shin,m.d.,inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3440 Lomita Blvd, Torrance, California |
| Authorized Official Name and Position | Peter B Shin (CEO) |
| Authorized Official Contact | 3103262161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter B. Shin,m.d.,inc 3440 Lomita Blvd 427 Torrance CA 90505-4801 Ph: (310) 326-2161 | Peter B. Shin,m.d.,inc 3440 Lomita Blvd 427 Torrance CA 90505-4801 Ph: (310) 326-2161 |
| NPI Number | 1740595396 |
|---|---|
| Provider Enumeration Date | 08/06/2010 |
| Last Update Date | 08/06/2010 |
| Medicare PECOS PAC ID | 4981737392 |
|---|---|
| Medicare Enrollment ID | O20100805000847 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740595396 | NPI | - | NPPES |
| 00A462710 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A46271 (California) | Primary |
| Provider Name | Peter B Shin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770590655 PECOS PAC ID: 5294859153 Enrollment ID: I20100830000099 |
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