Organization
GINOS WIDE SHOES & SHOE REPAIR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PABLO SERRANO JR. (OWNER)
(619) 433-4466
Entity
Organization
Contact information
Practice address
5500 GROSSMONT CENTER DR STE 141, STE 141, LA MESA, CA 91942-3070
(619) 433-4466
(619) 439-6787
Mailing address
5500 GROSSMONT CENTER DR STE 141, STE 141, LA MESA, CA 91942-3070
(619) 433-4466
(619) 439-6787
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
02/04/2026
Last updated
02/04/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up