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SE JUNG SHIN MD PROFESSIONAL CORPORATION NPI 1184829244


NPI Information

NPI: 1184829244
Provider Name: SE JUNG SHIN MD PROFESSIONAL CORPORATION

Doing Business As: CORNELL URGENT CARE

Classification: Emergency Medicine - 207P00000X
Entity Type: Organization
Address:
13305 NW CORNELL ROAD, SUITE C
PORTLAND, OR
ZIP 97229
Phone: (503) 646-8500
Get Directions

SE JUNG SHIN MD PROFESSIONAL CORPORATION is an emergency medicine in Portland, OR. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. SE JUNG SHIN MD PROFESSIONAL CORPORATION NPI is 1184829244. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Cornell Urgent Care.

The provider's business location address is:

13305 NW CORNELL ROAD, SUITE C
PORTLAND, OR
ZIP 97229
Phone: (503) 646-8500
Fax: (503) 646-8200

The provider's authorized official is Se Jung Shin .
The authorized official title is President and has the following contact phone number (503) 646-8500.

The enumeration date for this NPI number is 6/19/2007 and was last updated on 4/16/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207PE0004XEmergency MedicineEmergency Medical Services36696OREGONNo
2207PP0204XEmergency MedicinePediatric Emergency Medicine36696OREGONNo
3207P00000XEmergency Medicine36696OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1138485MEDICARE PINOREGON
21184829244OTHERNPI NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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