Healthcare Provider Details

I. General information

NPI: 1013821545
Provider Name (Legal Business Name): PREMISE HEALTH OF CALIFORNIA MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 SEAPORT CT STE 100
REDWOOD CITY CA
94063-2799
US

IV. Provider business mailing address

5500 MARYLAND WAY STE 120
BRENTWOOD TN
37027-4993
US

V. Phone/Fax

Practice location:
  • Phone: 650-451-5044
  • Fax: 650-649-2348
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: EDWARD WILLIAM SCHWARTZ
Title or Position: PRESIDENT
Credential:
Phone: 602-739-4561