Healthcare Provider Details

I. General information

NPI: 1508266404
Provider Name (Legal Business Name): MICHAEL R SCHWARTZ MD INC APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2014
Last Update Date: 08/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

696 HAMPSHIRE RD STE.# 210
WESTLAKE VILLAGE CA
91361-2699
US

IV. Provider business mailing address

696 HAMPSHIRE RD STE.#210
WESTLAKE VILLAGE CA
91361-2699
US

V. Phone/Fax

Practice location:
  • Phone: 805-449-7204
  • Fax: 805-830-0436
Mailing address:
  • Phone: 805-449-7204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberA4500
License Number StateCA

VIII. Authorized Official

Name: MICHAEL SCHWARTZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 805-449-7204