Individual
MISS ANNICA M SHUMNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1245 16TH ST STE 125, SANTA MONICA, CA 90404-1240
(310) 315-8900
(310) 315-8902
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-8707
(310) 301-8751
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
164005771
IL
363A00000X
Physician Assistant
085006632
IL
363A00000X
Physician Assistant
Primary
PA61459
CA
Other
Enumeration date
07/30/2015
Last updated
03/30/2023
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