Healthcare Provider Details

I. General information

NPI: 1922094382
Provider Name (Legal Business Name): MICHAEL S SCHWARTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 E GREEN ST #101
PASADENA CA
91106-2401
US

IV. Provider business mailing address

960 E GREEN ST #101
PASADENA CA
91106-2401
US

V. Phone/Fax

Practice location:
  • Phone: 626-793-5134
  • Fax: 626-793-2912
Mailing address:
  • Phone: 626-793-5134
  • Fax: 626-793-2912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberG50895
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: