Provider Demographics
NPI:1871594648
Name:SHULMAN, VALERY P (MD)
Entity type:Individual
Prefix:
First Name:VALERY
Middle Name:P
Last Name:SHULMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:VAL
Other - Middle Name:P
Other - Last Name:SHULMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:7559 SANTA MONICA BLVD
Mailing Address - Street 2:200
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-6406
Mailing Address - Country:US
Mailing Address - Phone:323-878-2523
Mailing Address - Fax:
Practice Address - Street 1:7559 SANTA MONICA BLVD
Practice Address - Street 2:200
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-6406
Practice Address - Country:US
Practice Address - Phone:323-878-2523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38820207Q00000X, 207QA0505X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA388200Medicaid
CA954586615OtherFEDERAL ID
CA954586615OtherFEDERAL ID
CAWA38820CMedicare ID - Type Unspecified