| Dr. Michael C. Shulkin,od | |
|
1188 Montgomery Dr Santa Rosa CA 95405-4802 | |
| (707) 542-3404 | |
| (707) 542-3404 |
| Full Name | Dr. Michael C. Shulkin,od |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1188 Montgomery Dr, Santa Rosa, California |
| Authorized Official Name and Position | Michael Charles Shulkin (OWNER) |
| Authorized Official Contact | 7075423404 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Michael C. Shulkin,od 1188 Montgomery Dr Santa Rosa CA 95405-4802 Ph: (707) 542-3404 | Dr. Michael C. Shulkin,od 1188 Montgomery Dr Santa Rosa CA 95405-4802 Ph: (707) 542-3404 |
| NPI Number | 1568646610 |
|---|---|
| Provider Enumeration Date | 12/26/2007 |
| Last Update Date | 03/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568646610 | NPI | - | NPPES |
| P00365795 | Other | CA | MEDICARE RAILROAD CARRIER |
| SD0077030 | Medicaid | CA | |
| ZZZ03669Z | Other | CA | MEDICARE (INCORPORATED) |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | OPT77030TPA (California) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | OPT77030TPA (California) | Primary |
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Thomas M. Collins Chiropractic, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1212 Farmers Ln, Suite 2, Santa Rosa, CA 95405 Phone: 707-566-7396 Fax: 707-566-7398 | |
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