Provider Demographics
NPI:1588602858
Name:SHULESHKO, JULIA (DO)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:SHULESHKO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 41486
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95160-1486
Mailing Address - Country:US
Mailing Address - Phone:408-476-1928
Mailing Address - Fax:
Practice Address - Street 1:9400 N NAME UNO
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-3528
Practice Address - Country:US
Practice Address - Phone:408-848-4949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6511207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF78626Medicare UPIN