MR. BRIAN JISU SHIN (NPI# 1144860404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144860404 |
| Entity Type | Individual |
| Full Name | MR. BRIAN JISU SHIN |
| Credential | PHYSICIAN ASSISTANT |
| Practice Address |
8293 Perla Dr Riverside CA 92504-2419 |
| Practice Telephone | 9512140212 |
| Mailing Telephone | 9512140212 |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2020-01-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194193136 | Brian Shin | Marriage & Family Therapist | 855 Bowsprit Rd Ste B, Chula Vista, CA 91914-4529 | 2015-09-08 |
| 1013156421 | Brian Jung Hyun Shin | Physical Therapist | 1820 Highway 20 Se, Ste 146, Conyers, GA 30013-2077 | 2009-02-09 |
| 1427182658 | Brian Shin | Dentist | 195 University Park Dr, Edwardsville, IL 62026-0001 | 2007-03-16 |
| 1265094247 | Brian Shin | Student in an Organized Health Care Education/Training Program | 205 N East Ave, Jackson, MI 49201-1753 | 2019-07-01 |
| 1316443963 | Brian S Shin | Student in an Organized Health Care Education/Training Program | 506 6th St, Brooklyn, NY 11215-3609 | 2018-04-03 |
| 1093247793 | Brian Chulmin Shin | Student in an Organized Health Care Education/Training Program | 4150 V St # 1200, Sacramento, CA 95817-1460 | 2017-03-31 |
| 1942349634 | Brian Yong-seop Shin | Internal Medicine | 13652 Cantara St, Panorama City, CA 91402-5423 | 2007-02-06 |
| 1194896134 | Brian Jai Shin | Radiology | 1011 Baldwin Park Blvd, Baldwin Park, CA 91706-5806 | 2006-11-13 |
| Street Address |
8293 PERLA DR |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92504-2419 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417573676 | Chloe Ivana Licon | Marriage & Family Therapist | New Beginnings Residential Treatment Facilities, 2900 Adams St, Riverside, CA 92504 | 2020-06-23 |
| 1720628993 | Palm Lily LLC | Non-emergency Medical Transport (VAN) | 2900 Adams Street Suite A435, Riverside, CA 92504 | 2020-01-15 |
| 1538630959 | Just for Kids Pediatric Dentistry Raymond Wang | Dentist | 7071 Indiana Ave, Riverside, CA 92504 | 2018-12-11 |
| 1477047835 | Deborah Kay Allen | Peer Specialist | 6939 Morningside Ave, Riverside, CA 92504 | 2018-06-19 |
| 1255833794 | Adiana Loya | Student in an Organized Health Care Education/Training Program | 7550 Orchard St Apt #58, Riverside, CA 92504 | 2018-03-01 |
| 1023524162 | Chiara Heyer | Counselor | 4130 Adams St Ste B, Riverside, CA 92504 | 2017-12-27 |
| 1801313408 | Gustavo Gallo Avelar | Behavioral Analyst | 4125 Rucker Ln, Riverside, CA 92504 | 2017-08-24 |
| 1891226205 | Susana Herold | Assistant Behavior Analyst | 17460 Krameria Ave, Riverside, CA 92504 | 2017-03-27 |
| 1710356167 | Erandi Portugal | Counselor | 6711 Alrington Avenue, Riverside, CA 92504 | 2015-09-16 |
| 1548636012 | Candace Lauren Bynder | Counselor | 6711 Arlington Avenue, Riverside, CA 92504 | 2015-08-19 |
| Find all providers in zip 92504 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447870365 | Monica Sameh Hanna | Student in an Organized Health Care Education/Training Program | University of California Riverside School of Medicine, 14350 Meridian Pkwy # 2, Riverside, CA 92518-3035 | 2020-04-21 |
| 1861011876 | Monika Ellyn Garcia | Student in an Organized Health Care Education/Training Program | 14350 Meridian Parkway Box #2, Riverside, CA 92518 | 2020-04-09 |
| 1568099976 | Victoria Lee | Student in an Organized Health Care Education/Training Program | Riverside Family Medicine Residency, 10800 Magnolia Avenue, Riverside, CA 92505 | 2020-03-25 |
| 1114553765 | Pamela Picchi | Student in an Organized Health Care Education/Training Program | 111 Prescott Ave, Riverside, RI 02915-1944 | 2020-03-16 |
| 1538794094 | Jason Washington | Student in an Organized Health Care Education/Training Program | 4301 La Sierra Ave Apt 50, Riverside, CA 92505-2906 | 2020-03-05 |
| 1609415116 | Broderich Alexander Durley | Student in an Organized Health Care Education/Training Program | 14235 Oakley Dr, Riverside, CA 92503-7236 | 2019-12-31 |
| 1861031353 | Alex Tovar | Student in an Organized Health Care Education/Training Program | 16901 Clementine Ct, Riverside, CA 92503-6935 | 2019-12-31 |
| 1477192979 | Gregory David White | Student in an Organized Health Care Education/Training Program | 7965 Los Arboles Pl, Riverside, CA 92504-3530 | 2019-12-31 |
| 1407497076 | Guadalupe Rocha | Student in an Organized Health Care Education/Training Program | 10135 Hillsborough Ln, Riverside, CA 92503-1018 | 2019-10-03 |
| 1326691494 | John Michael Stewart | Student in an Organized Health Care Education/Training Program | 4716 Cliffside Dr, Riverside, CA 92506-1076 | 2019-07-18 |
| Find all providers in RIVERSIDE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.