Healthcare Provider Details

I. General information

NPI: 1255986014
Provider Name (Legal Business Name): JOHANN JOSUE SCHLAGER OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2019
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3178 COLLINS DR STE A
MERCED CA
95348-3155
US

IV. Provider business mailing address

105 SPROUL CT
MERCED CA
95348-8564
US

V. Phone/Fax

Practice location:
  • Phone: 209-383-1246
  • Fax:
Mailing address:
  • Phone: 310-483-6282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number34586
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: