MEDICARE: DR. PAUL DOUGLAS SCHWARZ DMD, MBA

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	1223D0004X	Dental Anesthesiology	CS1172	CA
2	1223G0001X	General Practice Dentistry	100527	CA
3	1223G0001X	General Practice Dentistry	5543	NV
4	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	100527	CA

General Provider Information

NPI Number	:	1932371184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL DOUGLAS SCHWARZ DMD, MBA

Provider Business Mailing Address
First Line	:	538 RICHMOND ST
Second Line	:
City	:	EL SEGUNDO
State	:	CA
Zip	:	90245-2228
Country	:	US
Telephone Number	:	702-372-4073
Fax Number	:	702-361-6291

Provider Business Practice Location Address
First Line	:	538 RICHMOND ST
Second Line	:
City	:	EL SEGUNDO
State	:	CA
Zip	:	90245-2228
Country	:	US
Telephone Number	:	702-372-4073
Fax Number	:	702-361-6291

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

Provider Enumeration Date	:	03/27/2008
Last Update Date	:	09/09/2020

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