Healthcare Provider Details
I. General information
NPI: 1568667731
Provider Name (Legal Business Name): JOSEPH HASBROUCK SCHWAB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/18/2007
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
444 S SAN VICENTE BLVD
LOS ANGELES CA
90048-4165
US
IV. Provider business mailing address
4140 W 190TH ST
TORRANCE CA
90504-5513
US
V. Phone/Fax
- Phone: 310-423-9900
- Fax: 310-248-7399
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 233765 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0117X |
| Taxonomy | Orthopaedic Surgery of the Spine Physician |
| License Number | C191501 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: