Healthcare Provider Details

I. General information

NPI: 1578507869
Provider Name (Legal Business Name): CARRIE RENEE SCHWARTZ D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 09/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 N LA CIENEGA BLVD SUITE 107
WEST HOLLYWOOD CA
90069-2493
US

IV. Provider business mailing address

835 S SHENANDOAH ST
LOS ANGELES CA
90035-1703
US

V. Phone/Fax

Practice location:
  • Phone: 323-872-7363
  • Fax: 310-652-6562
Mailing address:
  • Phone: 323-872-7363
  • Fax: 310-652-6562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number28911
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8075
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: