Rostermundt, Shane D

Rostermundt, Shane D is an individual health care provider with primary practice located at 1430 E Main St 201, Santa Maria CA 93454. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Rostermundt, Shane D can be contacted via phone (805) 922-3548.

Contact Information

Primary practice address
1430 E Main St 201 Santa Maria CA 93454
Phone: (805) 922-3548
Fax: (805) 928-5609
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 20A9637 California

Profile Details

NPI number 1396846507
LBN Legal business name Rostermundt, Shane D
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2006
Last updated Jan 11th, 2011 - about 13 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 1396846507 NPPES
California MEDICAID YYY48371Y

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