Healthcare Provider Details

I. General information

NPI: 1356376164
Provider Name (Legal Business Name): JAMES SCHULTZ M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 03/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 N ELM ST
ESCONDIDO CA
92025-3002
US

IV. Provider business mailing address

425 N DATE ST
ESCONDIDO CA
92025-3413
US

V. Phone/Fax

Practice location:
  • Phone: 760-737-2000
  • Fax: 760-739-2039
Mailing address:
  • Phone: 760-737-2035
  • Fax: 760-741-2782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG61829
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: