Individual
DR. STEFANIE ANN MIKULICS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1050 LAS TABLAS RD, SUITE 2, TEMPLETON, CA 93465-9729
(805) 434-9441
(805) 434-9456
Mailing address
1050 LAS TABLAS RD, SUITE 2, TEMPLETON, CA 93465-9729
(805) 434-9441
(805) 434-9456
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
A68329
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A683290
BLUE SHIELD PIN
CA
05
—
00A683290
—
CA
05
—
GR0092204
—
CA
Enumeration date
07/20/2006
Last updated
04/14/2008
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