Healthcare Provider Details

I. General information

NPI: 1831157916
Provider Name (Legal Business Name): RICHARD J. SCHUMANN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16776 BERNARDO CENTER DR SUITE 209
SAN DIEGO CA
92128-2669
US

IV. Provider business mailing address

PO BOX 1770
LA MESA CA
91944-1770
US

V. Phone/Fax

Practice location:
  • Phone: 858-675-1112
  • Fax: 858-675-1141
Mailing address:
  • Phone: 619-464-1165
  • Fax: 619-567-1011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA62324
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberA62324
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: