Healthcare Provider Details

I. General information

NPI: 1740567650
Provider Name (Legal Business Name): MICHAEL J. SCHWAB, MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2011
Last Update Date: 11/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1844 SAN MIGUEL DR SUITE 110
WALNUT CREEK CA
94596-4962
US

IV. Provider business mailing address

1844 SAN MIGUEL DR SUITE 110
WALNUT CREEK CA
94596-4962
US

V. Phone/Fax

Practice location:
  • Phone: 925-930-7744
  • Fax:
Mailing address:
  • Phone: 925-930-7744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG36202
License Number StateCA

VIII. Authorized Official

Name: DR. MICHAEL J SCHWAB
Title or Position: PRESIDENT
Credential:
Phone: 925-930-7744