Healthcare Provider Details

I. General information

NPI: 1831231794
Provider Name (Legal Business Name): SHUMAN MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25500 MEDICAL CENTER DR
MURRIETA CA
92562-5965
US

IV. Provider business mailing address

25470 MEDICAL CENTER DR, SUITE 206
MURRIETA CA
92562
US

V. Phone/Fax

Practice location:
  • Phone: 951-973-7380
  • Fax: 951-973-7389
Mailing address:
  • Phone: 951-973-7380
  • Fax: 951-973-7389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG47796
License Number StateCA

VIII. Authorized Official

Name: DR. RICHARD KAY SHUMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 951-973-7380