Middleton, Ian James

Middleton, Ian James is an sole proprietor health care provider with primary practice located at 1559 Farmers Ln , Santa Rosa CA 95405-7525. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Middleton, Ian James can be contacted via phone (707) 571-2020.

Contact Information

Primary practice address
1559 Farmers Ln Santa Rosa CA 95405-7525
Phone: (707) 571-2020
Fax: (707) 540-6299
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 5308T California

Profile Details

NPI number 1144224791
LBN Legal business name Middleton, Ian James
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 10th, 2005
Last updated Jul 22nd, 2010 - about 16 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 1144224791 NPPES
California MEDICAID SD0053080

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