Stavn, Hollis Loren

Stavn, Hollis Loren is an sole proprietor health care provider with primary practice located at 2305 Mendocino Ave Ste B, Santa Rosa CA 95403-3157. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Stavn, Hollis Loren can be contacted via phone (707) 527-9137.

Contact Information

Primary practice address
2305 Mendocino Ave Ste B Santa Rosa CA 95403-3157
Phone: (707) 527-9137
Fax: (707) 545-9278
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 6812T California

Profile Details

NPI number 1194728527
LBN Legal business name Stavn, Hollis Loren
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 31st, 2005
Last updated Dec 20th, 2012 - 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 1194728527 NPPES
California Other 45719 SAGEGUARD
California MEDICAID SD0068121 SAGEGUARD

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