Provider Demographics
NPI:1477744480
Name:SHUMAN, ALISON W (MD)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:W
Last Name:SHUMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALISON
Other - Middle Name:WEEMS
Other - Last Name:CERESNAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5855 OLIVAS PARK DR # DT
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7672
Mailing Address - Country:US
Mailing Address - Phone:805-667-2801
Mailing Address - Fax:805-667-2865
Practice Address - Street 1:2921 SAVIERS RD
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-5314
Practice Address - Country:US
Practice Address - Phone:805-481-5855
Practice Address - Fax:805-487-5589
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236246208000000X
CAA101333208M00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA11797505OtherCAQH PROVIDER NUMBER
CAA101333OtherSTATE MEDICAL BOARD LICENSE
CAAQ294ZMedicare PIN
CAAQ294VMedicare PIN
CAAQ294YMedicare PIN
CA11797505OtherCAQH PROVIDER NUMBER
CAAQ294WMedicare PIN
CAAQ294SMedicare PIN
CAAQ294UMedicare PIN
CAAQ294TMedicare PIN