Provider Demographics
NPI:1295018984
Name:CRUM, SHAWN MICHAEL (DO, MPH)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:MICHAEL
Last Name:CRUM
Suffix:
Gender:M
Credentials:DO, MPH
Other - Prefix:
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Mailing Address - Street 1:16787 BEACH BLVD
Mailing Address - Street 2:337
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-4848
Mailing Address - Country:US
Mailing Address - Phone:714-903-7767
Mailing Address - Fax:714-903-7801
Practice Address - Street 1:16787 BEACH BLVD
Practice Address - Street 2:337
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-4848
Practice Address - Country:US
Practice Address - Phone:714-903-7767
Practice Address - Fax:714-903-7801
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2016-05-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
282N00000X
CA20A1244207R00000X
CA12244207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No282N00000XHospitalsGeneral Acute Care Hospital
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine