Healthcare Provider Details

I. General information

NPI: 1780836932
Provider Name (Legal Business Name): MELVYN S. SCHWARZ D.D.S,, M.CS.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 10/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 LOMITA BLVD STE 505
TORRANCE CA
90505-4990
US

IV. Provider business mailing address

3400 LOMITA BLVD STE 505
TORRANCE CA
90505-4990
US

V. Phone/Fax

Practice location:
  • Phone: 310-325-9969
  • Fax: 310-534-0027
Mailing address:
  • Phone: 310-325-9969
  • Fax: 310-534-0027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number17171
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: