Healthcare Provider Details

I. General information

NPI: 1922749860
Provider Name (Legal Business Name): DR. GREGORY SHINAMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4860 Y ST STE 3020
SACRAMENTO CA
95817-2307
US

IV. Provider business mailing address

4860 Y ST STE 3020
SACRAMENTO CA
95817-2307
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-1574
  • Fax: 916-734-2975
Mailing address:
  • Phone: 916-734-1574
  • Fax: 916-734-2975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberA206693
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: