Shao, Gina C
Shao, Gina C is an individual health care provider with primary practice located at 2322 E Thousand Oaks Blvd , Thousand Oaks CA 91362-3206. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Shao, Gina C can be contacted via phone (805) 557-1055.Contact Information
Primary practice address
2322 E Thousand Oaks Blvd
Thousand Oaks CA 91362-3206
Phone: (805) 557-1055
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 12441T | California |
Profile Details
| NPI number | 1023113107 |
|---|---|
| LBN Legal business name | Shao, Gina C |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 14th, 2006 |
| Last updated | Jun 4th, 2015 - about 11 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 | 1023113107 | NPPES |
| California | MEDICAID | SD0124410 |
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