IndividualActive
Shane Wallin
NPI 1104282177 · Medical Art Specialist/Technologist · San Diego, CA
Provider details
- NPI number
- 1104282177
- Entity type
- Individual
- Primary specialty
- Medical Art Specialist/TechnologistTechnologists, Technicians & Other Technical Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 310143 (MN)
Mailing address
1968 Garnet Ave
San Diego, CA 92109-3555
Registry dates
- Enumerated
- 2016-01-06
- Last updated
- 2025-07-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.