Provider Demographics
NPI:1144355769
Name:ADAM B SHERMAN D O PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:ADAM B SHERMAN D O PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:805-487-7000
Mailing Address - Street 1:532 N VENTURA RD
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-4807
Mailing Address - Country:US
Mailing Address - Phone:805-487-7000
Mailing Address - Fax:805-487-7676
Practice Address - Street 1:532 N VENTURA RD
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-4807
Practice Address - Country:US
Practice Address - Phone:805-487-7000
Practice Address - Fax:805-487-7676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7318207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
610234200OtherUSDL
DD3902Medicare PIN
610234200OtherUSDL