Provider Demographics
NPI:1164400834
Name:SHUMAN, RICHARD KAY (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:KAY
Last Name:SHUMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25470 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4900
Mailing Address - Country:US
Mailing Address - Phone:951-973-7380
Mailing Address - Fax:951-973-7389
Practice Address - Street 1:25500 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5965
Practice Address - Country:US
Practice Address - Phone:951-973-7380
Practice Address - Fax:951-973-7389
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG47796207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G477960Medicare ID - Type Unspecified