Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Shirley Lynne Van, MD

Individual provider Dermatology Physician · NPI 1063530749

Dr. Shirley Lynne Van, MD is a Dermatology in San Luis Obispo, California. Graduated from University of Miami, Lm Miller School of Medicine in 1982, 44 years ago. Practices as a sole proprietor, works from 2 locations and accepts Medicare assignment. Licensed in California.

Years since qualifying
44
Trained at
University of Miami, Lm Miller School of Medicine
Licensed in
CA
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

862 Aerovista Pl Ste 100
San Luis Obispo, CA 93401-8758
Phone: (805) 549-8023
Fax: (805) 549-8252
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 26800 Crown Valley Pkwy Ste 435, Mission Viejo, CA 92691-8023 — (949) 573-9510

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence G51607 (CA)

Record details

NPI number1063530749
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 27, 2007
Last updated in NPPESOctober 1, 2025
Certification dateOctober 1, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolUNIVERSITY OF MIAMI, LM MILLER SCHOOL OF MEDICINE
Graduated 1982 (44 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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