Lundgren, Daniel Julien

Lundgren, Daniel Julien is an individual health care provider with primary practice located at 4601 Dale Rd , Modesto CA 95356-9718. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Lundgren, Daniel Julien can be contacted via phone (209) 735-3150.

Contact Information

Primary practice address
4601 Dale Rd Modesto CA 95356-9718
Fax: (209) 735-3155
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 9435T California

Profile Details

NPI number 1811986375
LBN Legal business name Lundgren, Daniel Julien
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2005
Last updated Jan 3rd, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811986375 NPPES
Other 410047220 RAILROAD MEDICARE
MEDICAID SD0094350 RAILROAD MEDICARE

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