Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY 17891 | CA |
Y | 103TC0700X | Clinical Psychologist | PSY 17891 | CA |
NPI | 1013005677 |
---|---|
Provider Name | Dr. Paul G Shuman |
First Address | Downey, CA 90242-2001 |
Second Address | Downey, CA 90242-2001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PSY 17891 | LIC NUMBER (01) | CA |