GINOS WIDE SHOES & SHOE REPAIR – NPI #1073464350
Durable Medical Equipment & Medical Supplies

A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Health Care Provider Taxonomy Code for Durable Medical Equipment & Medical Supplies

GINOS WIDE SHOES & SHOE REPAIR is a DME supplier located in LA MESA, CA. NPPES has assigned the NPI number 1073464350 to GINOS WIDE SHOES & SHOE REPAIR on February 04, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 332B00000X from the Health Care Provider Taxonomy code set, which is classified as Durable Medical Equipment & Medical Supplies.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GINOS WIDE SHOES & SHOE REPAIR below.

NPI Profile for
GINOS WIDE SHOES & SHOE REPAIR

NPI Number
1073464350
Enumeration Date

(about 4 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GINOS WIDE SHOES & SHOE REPAIR
Primary location
5500 GROSSMONT CENTER DR STE 141
STE 141
LA MESA, CA 91942-3070
Phone: (619) 433-4466 Fax: (619) 439-6787
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
PABLO SERRANO
OWNER
Phone: (619) 433-4466
Updated
Certification Date
Feb 04, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
332B00000X
- Durable Medical Equipment & Medical Supplies (Primary)
335E00000X
- Prosthetic/Orthotic Supplier

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.