Provider Demographics
NPI:1407526106
Name:SHINNO, MELANIE (DPT)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:SHINNO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 N BELLFLOWER BLVD UNIT 136
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90814-4207
Mailing Address - Country:US
Mailing Address - Phone:626-372-5590
Mailing Address - Fax:
Practice Address - Street 1:640 S PLACENTIA AVE
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-6300
Practice Address - Country:US
Practice Address - Phone:714-579-7772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist