GLENN JUN SHINTAKU (NPI# 1861472409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861472409 |
| Entity Type | Individual |
| Full Name | GLENN JUN SHINTAKU |
| Credential | DPM |
| Practice Address |
1212 W Gardena Blvd Ste B Gardena CA 90247 |
| Practice Telephone | 3105382982 |
| Mailing Telephone | 3105382982 |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2010-02-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | E2649 | CA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 000E26490 | 05 |
| Street Address |
1212 W GARDENA BLVD STE B |
| City | GARDENA |
| State | CA |
| Zip Code | 90247 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204707 | Melissa Reyes | Home Health Aide | 835 N Rosecrans Ave Apt 125, Gardena, CA 90247 | 2020-10-30 |
| 1538645569 | Christopher Jabarie Markham | Case Manager/Care Coordinator | 12817 S Hoover St Apt 14, Gardena, CA 90247 | 2018-07-12 |
| 1013404243 | Sunshine Community Resource Organization Center | Counselor | 1202 W 135th Street, Gardena, CA 90247 | 2018-04-13 |
| 1124537261 | Nina Vu | Pharmacist | 14416 Plum Lane, Unit 3, Gardena, CA 90247 | 2017-09-20 |
| 1356871008 | Delaram Moshfegh | Pharmacist | 1735 Artesia Blvd, Gardena, CA 90247 | 2017-06-15 |
| 1497290522 | Better Vision Optical | Eyewear Supplier (Equipment, not the service) | 1121 W Gardena Blvd Ste A, Gardena, CA 90247 | 2016-12-28 |
| 1013394832 | Lydia Gonzalez | Case Management | 13605 S Vermont Ave Apt 16, Gardena, CA 90247 | 2015-04-30 |
| 1396147682 | Daniel Medical Group, Inc. | Acupuncturist | 2015 W Redondo Beach Blvd., Ste F, Gardena, CA 90247 | 2014-09-18 |
| 1386913663 | Linda Doreen Humphries | Nurse Practitioner | 1141 W. Redondo Beach Blvd., Suite 402, Gardena, CA 90247 | 2011-12-15 |
| 1215229547 | Everett D Wong | Social Worker | 1045 W Redondo Beach Blvd Ste 150, Gardena, CA 90247 | 2011-05-04 |
| Find all providers in zip 90247 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255778726 | John Jinn-jyh Shun | Podiatrist | 1045 W Redondo Beach Blvd Ste 106, Gardena, CA 90247-4276 | 2013-05-23 |
| 1013012368 | Lawrence Ira Rubin | Podiatrist | 1045 W Redondo Bch Blvd, Suite 250, Gardena, CA 90247 | 2006-09-13 |
| 1154361871 | Rabin Beral | Podiatrist | 1141 W Redondo Beach Blvd Ste 302, Gardena, CA 90247-3583 | 2006-06-08 |
| 1982894572 | Lawrence I Rubin Dpm, Inc | Podiatrist | 1045 W Redondo Beach Blvd, #250, Gardena, CA 90247-4128 | 2007-07-30 |
| 1679686976 | Bryce Kiyoshi Yamauchi | Podiatrist | 1300 W 155th St, #210, Gardena, CA 90247-4061 | 2006-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649884610 | South Bay Foot & Ankle Specialists, Inc. | Podiatrist | 5565 Grossmont Center Dr Ste 510, La Mesa, CA 91942-3024 | 2020-09-07 |
| 1811512866 | Ankle & Foot Care Center Inc | Podiatrist | 15141 Whittier Blvd Ste 330, Whittier, CA 90603-2168 | 2020-06-15 |
| 1912528928 | Clement Podiatry PC | Podiatrist | 505 Sansome St Ste 850, San Francisco, CA 94111-3114 | 2020-04-30 |
| 1942834775 | Felix Sigal Dpm A Professional Corporation | Podiatrist | 201 S Alvarado St Ste 819, Los Angeles, CA 90057-2391 | 2020-03-02 |
| 1033758339 | Yosemite Bone and Joint Inc | Podiatrist | 1199 Delbon Ave Ste 1, Turlock, CA 95382-2006 | 2020-01-03 |
| 1194361634 | K David Flora Dpm Inc | Podiatrist | 1086 N Cherry St, Tulare, CA 93274-2251 | 2019-11-19 |
| 1902457963 | Silverlake Virgil Surgery Center | Podiatrist | 3367 W 1st St Ste 204, Los Angeles, CA 90004-6080 | 2019-09-21 |
| 1134778178 | Mohamad Belal Sharif | Podiatrist | Va Loma Linda 11201 Benton St, Loma Linda, CA 92357-0001 | 2019-09-11 |
| 1972159366 | Bay Area Surgical Specialists Inc A Medical Corporation | Podiatrist | 6061 N 1st St Ste 103, Fresno, CA 93710-5470 | 2019-08-13 |
| 1790331189 | Bay Area Surgical Specialists Inc A Medical Corporation | Podiatrist | 774 N Prospect St Ste B, Porterville, CA 93257-1941 | 2019-08-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.