Provider Demographics
NPI:1548285794
Name:SHULKIN, EDWIN S (MD)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:S
Last Name:SHULKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12840 RIVERSIDE DR
Mailing Address - Street 2:#206
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91607
Mailing Address - Country:US
Mailing Address - Phone:818-508-9190
Mailing Address - Fax:818-508-1648
Practice Address - Street 1:12840 RIVERSIDE DR
Practice Address - Street 2:#206
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91607
Practice Address - Country:US
Practice Address - Phone:818-508-9190
Practice Address - Fax:818-508-1648
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC24844207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine