MEDICARE: DR. RONALD HULNICK PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MS 16357	CA

General Provider Information

NPI Number	:	1285843706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD HULNICK PH.D.

Provider Business Mailing Address
First Line	:	21130 BELLINI DR
Second Line	:
City	:	TOPANGA
State	:	CA
Zip	:	90290-4408
Country	:	US
Telephone Number	:	818-999-1589
Fax Number	:	818-999-1418

Provider Business Practice Location Address
First Line	:	2107 WILSHIRE BLVD
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-5735
Country	:	US
Telephone Number	:	310-829-7402
Fax Number	:	310-453-5641

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	07/08/2007

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