Provider Demographics
NPI:1053572107
Name:JOSEPHSON SHULMAN, PAULA STACI (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:STACI
Last Name:JOSEPHSON SHULMAN
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3849 TILDEN AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-3976
Mailing Address - Country:US
Mailing Address - Phone:310-202-1771
Mailing Address - Fax:
Practice Address - Street 1:1301 20TH ST STE 270
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2053
Practice Address - Country:US
Practice Address - Phone:310-828-8585
Practice Address - Fax:310-453-4844
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110038207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program