Healthcare Provider Details

I. General information

NPI: 1790084671
Provider Name (Legal Business Name): SCHULTZ SURGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2011
Last Update Date: 03/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W. AVENUE J
LANCASTER CA
93534-2814
US

IV. Provider business mailing address

29054 HIGH SIERRA TRAIL
SANTA CLARAA CA
91390
US

V. Phone/Fax

Practice location:
  • Phone: 281-462-1285
  • Fax: 281-462-1554
Mailing address:
  • Phone: 281-462-1285
  • Fax: 281-462-1554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DAWN SCHULTZ
Title or Position: OWNER
Credential: RNFA
Phone: 281-462-1285