Healthcare Provider Details

I. General information

NPI: 1508435751
Provider Name (Legal Business Name): PREMISE HEALTH OF CALIFORNIA MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 VELOCITY WAY
FOSTER CITY CA
94404-4803
US

IV. Provider business mailing address

5500 MARYLAND WAY
BRENTWOOD TN
37027-7048
US

V. Phone/Fax

Practice location:
  • Phone: 650-524-0820
  • Fax: 650-267-6148
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EDWARD WILLIAM SCHWARTZ
Title or Position: PRESIDENT
Credential:
Phone: 844-407-7557