MEDICARE: DR. LAUREL JEANINE SCHRAMM M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	A66485	CA

General Provider Information

NPI Number	:	1376535690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAUREL JEANINE SCHRAMM M.D.

Provider Business Mailing Address
First Line	:	1616 S CREST DR
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90035-3316
Country	:	US
Telephone Number	:	310-860-1616
Fax Number	:	310-273-9330

Provider Business Practice Location Address
First Line	:	9033 WILSHIRE BLVD
Second Line	:	SUITE 300
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-1837
Country	:	US
Telephone Number	:	310-860-1616
Fax Number	:	310-273-9330

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	07/09/2007

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