Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Bo Kyong Shin, DPM

Individual provider Podiatrist · NPI 1568769149

Dr. Bo Kyong Shin, DPM is a Podiatry in Los Angeles, California. Qualified in 2008, 18 years ago. Practices with Gracelight Community Health, a 25-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New Jersey and New York.

Years since qualifying
18
Licensed in
NJ, NY
In the registry since
2011
Specialties on file
2
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4618 Fountain Ave
Los Angeles, CA 90029-1830
Phone: (323) 953-7170
Fax: (323) 663-2379
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 150 N Reno St, Los Angeles, CA 90026-4656 — (213) 380-7298

Specialties & licences

Podiatrist (primary) Taxonomy 213E00000X · Licence 25MD00308100 (NJ)
Podiatrist Taxonomy 213E00000X · Licence 006460 (NY)

Record details

NPI number1568769149
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPM
Sole proprietorYes
NPI enumeratedFebruary 17, 2011
Last updated in NPPESSeptember 28, 2023
Certification dateSeptember 28, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Gracelight Community Health — 25 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Los Angeles