Basic Information
| Provider Information | |||||||||
| NPI: | 1114284023 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHULMAN | ||||||||
| FirstName: | DANIEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4700 W SUNSET BLVD | ||||||||
| Address2: | KAISER PERMANENTE ADDICTION MEDICINE | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900276082 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3237838206 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1505 N EDGEMONT ST FL 3 | ||||||||
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| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900275209 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3237838206 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2012 | ||||||||
| LastUpdateDate: | 11/11/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | 86689 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.