MEDICARE: VALERY P SHULMAN M.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	207Q00000X	Family Medicine Physician	A38820	CA
2	207QA0505X	Adult Medicine Physician	A38820	CA
3	207QG0300X	Geriatric Medicine (Family Medicine) Physician	A38820	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	954586615	OTHER	CA	FEDERAL ID

General Provider Information

NPI Number	:	1871594648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERY P SHULMAN M.D.

Provider Business Mailing Address
First Line	:	7559 SANTA MONICA BLVD
Second Line	:	200
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-6406
Country	:	US
Telephone Number	:	323-878-2523
Fax Number	:

Provider Business Practice Location Address
First Line	:	7559 SANTA MONICA BLVD
Second Line	:	200
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90046-6406
Country	:	US
Telephone Number	:	323-878-2523
Fax Number	:

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	06/23/2010

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Directions to “ VALERY P SHULMAN M.D.” Practice Location

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