Shane Wallin
NPI #1104282177 in San Diego, California
Provider Information
- NPI Number
- 1104282177
- Entity Type
- Individual
- Name
- Shane Wallin
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist, Other - Art, Medical
- Enumeration Date
- Jan 6, 2016
- Last Updated
- Jul 3, 2025
Practice Location
- Address
- 1968 GARNET AVE
- City
- San Diego
- State
- California
- ZIP Code
- 92109-3555
- Phone
- (612) 214-1325
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist, Other - Art, Medical — Art, Medical |
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