DR. MICHAEL C. SHULKINOD NPI 1568646610

NPI Information

NPI: 1568646610
Provider Name: DR. MICHAEL C. SHULKIN,OD
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
1188 MONTGOMERY DR
SANTA ROSA, CA
ZIP 95405
Phone: (707) 542-3404
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DR. MICHAEL C. SHULKIN,OD is a primary care clinic center in Santa Rosa, CA. DR. MICHAEL C. SHULKIN,OD NPI is 1568646610. The provider is registered as an organization entity type.

The provider's business location address is:

1188 MONTGOMERY DR
SANTA ROSA, CA
ZIP 95405-802
Phone: (707) 542-3404
Fax: (707) 542-3404

The provider's authorized official is Michael Charles Shulkin .
The authorized official title is Owner and has the following contact phone number (707) 542-3404.

The enumeration date for this NPI number is 12/26/2007 and was last updated on 3/27/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261Q00000X	Clinic/Center		OPT77030TPA	CALIFORNIA	No
2	261QP2300X	Clinic/Center	Primary Care	OPT77030TPA	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	SD0077030	MEDICAID	CALIFORNIA
2	P00365795	OTHER	CALIFORNIA	MEDICARE RAILROAD CARRIER
3	U05252	MEDICARE UPIN	CALIFORNIA
4	0468990001	MEDICARE NSC	CALIFORNIA
5	ZZZ03669Z	OTHER	CALIFORNIA	MEDICARE (INCORPORATED)

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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