Shulkin, Michael C

Shulkin, Michael C is an sole proprietor health care provider with primary practice located at 1188 Montgomery Dr , Santa Rosa CA 95405-4802. He recently has 6 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Vision Therapy, Eye and Vision Services Providers / Occupational Vision. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Shulkin, Michael C can be contacted via phone (707) 542-3404.

Contact Information

Primary practice address
1188 Montgomery Dr Santa Rosa CA 95405-4802
Fax: (707) 542-3404
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPT7703TPA California
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X OPT7703TPA California
Eye and Vision Services Providers / Pediatrics 152WP0200X OPT7703TPA California
Eye and Vision Services Providers / Sports Vision 152WS0006X OPT7703TPA California
Eye and Vision Services Providers / Vision Therapy 152WV0400X OPT7703TPA California
Eye and Vision Services Providers / Occupational Vision 152WX0102X OPT7703TPA California

Profile Details

NPI number 1790893824
LBN Legal business name Shulkin, Michael C
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 28th, 2006
Last updated Jul 16th, 2010 - about 14 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 1790893824 NPPES
California MEDICAID SD0077030

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