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Dr. Michael C. Shulkin,od
Primary Care Clinic/Center in Santa Rosa, California
NPI 1568646610

Dr. Michael C. Shulkin,od is a Primary Care Clinic/Center based in Santa Rosa, CA and is specialized in Primary Care. Dr. Michael C. Shulkin,od practices in Santa Rosa, CA. The NPI Number for Dr. Michael C. Shulkin,od is 1568646610 and holds a License No. OPT77030TPA (California).

The current practice location address for Dr. Michael C. Shulkin,od is 1188 Montgomery Dr, Santa Rosa, CA and can be reached out via phone at 707-542-3404 and via fax at 707-542-3404.

Location: 1188 Montgomery Dr, Santa Rosa, CA, 95405-4802
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1568646610
Provider Name
Dr. Michael C. Shulkin,od
Credential
Provider Entity Type
Organization
Address
1188 Montgomery Dr, Santa Rosa, CA, 95405-4802
Phone Number
707-542-3404
Fax Number
707-542-3404
Provider Enumeration Date
12/26/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
P00365795 01 CA MEDICARE RAILROAD CARRIER
SD0077030 05 CA
ZZZ03669Z 01 CA MEDICARE (INCORPORATED)
institution
Provider Business Practice Location Address Details
Address
1188 Montgomery Dr
City
Santa Rosa
State
California
Zip
95405-4802
Phone Number
707-542-3404
Fax Number
707-542-3404
person
Provider Business Mailing Address Details
Address
1188 Montgomery Dr
City
Santa Rosa
State
California
Zip
95405-4802
Phone Number
707-542-3404
Fax Number
707-542-3404
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
OPT77030TPA (California)
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
OPT77030TPA (California)
Definition
Definition to come...
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