DR. MICHAEL C. SHULKINOD NPI 1568646610

NPI Information

  • NPI: 1568646610
  • Provider Name: DR. MICHAEL C. SHULKIN,OD
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Address: 1188 MONTGOMERY DR
    SANTA ROSA, CA
    ZIP 95405
  • Phone: (707) 542-3404

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NPI Details

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
1261Q00000XClinic/CenterOPT77030TPACALIFORNIANo
2261QP2300XClinic/CenterPrimary CareOPT77030TPACALIFORNIAYes

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
1SD0077030MEDICAIDCALIFORNIA
2P00365795OTHERCALIFORNIAMEDICARE RAILROAD CARRIER
3U05252MEDICARE UPINCALIFORNIA
40468990001MEDICARE NSCCALIFORNIA
5ZZZ03669ZOTHERCALIFORNIAMEDICARE (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: 3/30/2025

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