Doctor Name: | IRINA SHULGINA |
NPI Number: | 1376634774 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PAC |
License Number: | PA16372 |
Business Practice Address: | 5810 Jameson Ct Ste 1 Carmichael, CA - 95608 |
Business Phone Number: | 9169790621 |
Business Fax Number: | 9169791110 |
Mailing Address: | 5810 Jameson Ct, Ste 1 CARMICHAEL |
State: | CA |
Postal Code: | 95608 |
Phone Number: | 9169790621 |
Fax Number: | 9169791110 |
NPI Enumeration Date: | 09/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | PA16372 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |