Healthcare Provider Details

I. General information

NPI: 1003417833
Provider Name (Legal Business Name): TOTAL LIPEDEMA CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2020
Last Update Date: 11/06/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 S LA CIENEGA BLVD STE 200
BEVERLY HILLS CA
90211-3340
US

IV. Provider business mailing address

240 S LA CIENEGA BLVD STE 200
BEVERLY HILLS CA
90211-3340
US

V. Phone/Fax

Practice location:
  • Phone: 310-882-5454
  • Fax: 310-882-5454
Mailing address:
  • Phone: 310-882-5454
  • Fax: 310-882-5454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAIME SCOTT SCHWARTZ
Title or Position: OWNER
Credential: M.D.
Phone: 310-882-5454