Healthcare Provider Details

I. General information

NPI: 1700013265
Provider Name (Legal Business Name): JOSHUA M. SCHULMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2009
Last Update Date: 06/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10535 HOSPITAL WAY VA DERMATOLOGY CLINIC, BLDG 801
MATHER CA
95655-4200
US

IV. Provider business mailing address

10535 HOSPITAL WAY VA DERMATOLOGY CLINIC, BLDG 801
MATHER CA
95655-4200
US

V. Phone/Fax

Practice location:
  • Phone: 530-752-9767
  • Fax:
Mailing address:
  • Phone: 530-752-9767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL-240660
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA114583
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberA114583
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: