Healthcare Provider Details

I. General information

NPI: 1376535690
Provider Name (Legal Business Name): LAUREL JEANINE SCHRAMM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/22/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9033 WILSHIRE BLVD SUITE 300
BEVERLY HILLS CA
90211-1837
US

IV. Provider business mailing address

1616 S CREST DR
LOS ANGELES CA
90035-3316
US

V. Phone/Fax

Practice location:
  • Phone: 310-860-1616
  • Fax: 310-273-9330
Mailing address:
  • Phone: 310-860-1616
  • Fax: 310-273-9330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA66485
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: