Shipley, Les Alan
Shipley, Les Alan is an sole proprietor health care provider with primary practice located at 1430 Guerneville Rd Ste 3, Santa Rosa CA 95403. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Shipley, Les Alan can be contacted via phone (707) 525-9920.Contact Information
Primary practice address
1430 Guerneville Rd Ste 3
Santa Rosa CA 95403
Phone: (707) 525-9920
Fax: (707) 525-0844
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 5775T | California |
Profile Details
| NPI number | 1225011653 |
|---|---|
| LBN Legal business name | Shipley, Les Alan |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 21st, 2005 |
| Last updated | May 18th, 2015 - about 9 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 | 1225011653 | NPPES |
| California | MEDICAID | SD0057750 |
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