Shaunette, Gina Maria
Shaunette, Gina Maria is an individual health care provider with primary practice located at 5520 Whittier Blvd , Los Angeles CA 90022-4104. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Shaunette, Gina Maria can be contacted via phone (323) 728-2708.Contact Information
Primary practice address
5520 Whittier Blvd
Los Angeles CA 90022-4104
Phone: (323) 728-2708
Fax: (323) 728-0096
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 10415T | California |
Profile Details
| NPI number | 1598751430 |
|---|---|
| LBN Legal business name | Shaunette, Gina Maria |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 26th, 2005 |
| Last updated | Jul 9th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598751430 | NPPES |
| California | MEDICAID | SD0104150 |
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