Healthcare Provider Details

I. General information

NPI: 1710600473
Provider Name (Legal Business Name): JAMES SCHOTTER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JAMES DAY JR.

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 06/09/2023
Certification Date: 06/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PINE AVE STE 400
LONG BEACH CA
90802-3039
US

IV. Provider business mailing address

1062 1/2 N NORMAN CT
LONG BEACH CA
90813-3795
US

V. Phone/Fax

Practice location:
  • Phone: 770-595-1542
  • Fax:
Mailing address:
  • Phone: 770-595-1542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: