Healthcare Provider Details

I. General information

NPI: 1730951575
Provider Name (Legal Business Name): MAX A. SCHIMMEL MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2023
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3155 OLSEN DR STE 375
SAN JOSE CA
95117-1688
US

IV. Provider business mailing address

208 PINE CT
WHEELING WV
26003-8022
US

V. Phone/Fax

Practice location:
  • Phone: 888-688-9296
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPC020151
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: