Provider Demographics
NPI:1295346534
Name:YOSHIDA, SHAWN MASAMI
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:MASAMI
Last Name:YOSHIDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8803 HERMOSA DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-1816
Mailing Address - Country:US
Mailing Address - Phone:626-589-1694
Mailing Address - Fax:
Practice Address - Street 1:8803 HERMOSA DR
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-1816
Practice Address - Country:US
Practice Address - Phone:626-589-1694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist