Provider Demographics
NPI:1437241635
Name:SHERMAN, JULIE ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1703 TERMINO AVE
Mailing Address - Street 2:STE 209
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-2128
Mailing Address - Country:US
Mailing Address - Phone:562-498-3002
Mailing Address - Fax:562-498-3822
Practice Address - Street 1:1703 TERMINO AVE STE 209
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-2128
Practice Address - Country:US
Practice Address - Phone:562-498-3002
Practice Address - Fax:562-498-3822
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6794207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX67940Medicaid
CA20A6794Medicare ID - Type UnspecifiedMEDICARE
CA00AX67940Medicaid