Healthcare Provider Details

I. General information

NPI: 1134137722
Provider Name (Legal Business Name): MARK H SCHWAB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 MANGROVE AVE
CHICO CA
95926-3509
US

IV. Provider business mailing address

1040 MANGROVE AVE
CHICO CA
95926-3509
US

V. Phone/Fax

Practice location:
  • Phone: 530-345-0064
  • Fax:
Mailing address:
  • Phone: 530-345-0064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number00027258
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA104792
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA104792
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: