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General NPI Number Information
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NPI Number | 1265685978
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Entity Type | Organization
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Legal Business Name | TAMMY C. SHINEN, O.D., INC.
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Dates
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Enumeration Date | 10/25/2008
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Last Update Date | 10/25/2008
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Provider Practice Location Address
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Address Line | 15390 FAIRFIELD RANCH RD SUITE E
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City | CHINO HILLS
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State | CA
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Zip | 91709-8854
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Country | US
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Telephone | 909-606-0603
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Fax |
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Provider Business Mailing Address
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Address Line | 15390 FAIRFIELD RANCH RD SUITE E
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City | CHINO HILLS
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State | CA
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Zip | 91709-8854
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. TAMMY SHINEN
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Credential | O.D.
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Telephone | 909-606-0603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 11956T
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License Number State | CA
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