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
Phone: (707) 542-3404
Fax: (707) 542-3404
Website:
Health care specialties
| Specialty | Code | License # | 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 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790893824 | NPPES |
| California | MEDICAID | SD0077030 |
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