NPI 1104282177

Shane Wallin

Practitioner Medical Art Specialist/Technologist San Diego, CA

Practice location

Address: 1968 Garnet Ave, San Diego, CA 92109-3555
Phone: (612) 214-1325

Registered specialties

Medical Art Specialist/Technologist Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246ZA2600X Licence 310143 (MN)

Other Specialist/Technologist, Other providers in California →

Registry record

NPI: 1104282177
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Jan 2016
Record last updated: 3 Jul 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.