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NPI Profile for SHANE WALLIN in SAN DIEGO, CA.
Deactivation Date: 3/31/2023
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical Art Specialist/Technologist |
246ZA2600X |
| NPI Number | 1104282177 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 01/06/2016 | |
| Last updated | 07/03/2025 - About 11 months ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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SHANE WALLIN
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SHANE WALLIN