Healthcare Provider Details

I. General information

NPI: 1215940762
Provider Name (Legal Business Name): JAMES SCHWANKE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 24TH ST
SAN FRANCISCO CA
94114-3904
US

IV. Provider business mailing address

66 MANCHESTER ST
SAN FRANCISCO CA
94110-5215
US

V. Phone/Fax

Practice location:
  • Phone: 415-641-1019
  • Fax: 415-826-1308
Mailing address:
  • Phone: 415-641-1019
  • Fax: 415-826-1308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG28253
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: