Healthcare Provider Details

I. General information

NPI: 1962184127
Provider Name (Legal Business Name): MARIE-CLAIRE SCHILLINGER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 07/23/2024
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18411 CLARK ST STE 302
TARZANA CA
91356-3541
US

IV. Provider business mailing address

18411 CLARK ST STE 302
TARZANA CA
91356-3541
US

V. Phone/Fax

Practice location:
  • Phone: 818-501-7276
  • Fax:
Mailing address:
  • Phone: 818-501-7276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number63138
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: