Provider Demographics
NPI:1265685978
Name:TAMMY C. SHINEN, O.D., INC.
Entity Type:Organization
Organization Name:TAMMY C. SHINEN, O.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHINEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:909-606-0603
Mailing Address - Street 1:15390 FAIRFIELD RANCH RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-8854
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15390 FAIRFIELD RANCH RD
Practice Address - Street 2:SUITE E
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-8854
Practice Address - Country:US
Practice Address - Phone:909-606-0603
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-25
Last Update Date:2008-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11956T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty