MEDICARE: SARAH SHIMANEK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	292330	CA

General Provider Information

NPI Number	:	1063954287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH SHIMANEK

Provider Business Mailing Address
First Line	:	2329 STEARNLEE AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90815-1936
Country	:	US
Telephone Number	:	562-444-5326
Fax Number	:

Provider Business Practice Location Address
First Line	:	2599 E 28TH ST STE 206
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90755
Country	:	US
Telephone Number	:	562-444-5326
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2016
Last Update Date	:	06/25/2019

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Directions to “ SARAH SHIMANEK ” Practice Location

Language	Start Address	Practice Location

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