Healthcare Provider Details

I. General information

NPI: 1952673592
Provider Name (Legal Business Name): ADAM SCHULTE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2012
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 PROSPECT AVE UNIT 100
YORBA LINDA CA
92886-1742
US

IV. Provider business mailing address

3700 PROSPECT AVE UNIT 100
YORBA LINDA CA
92886-1742
US

V. Phone/Fax

Practice location:
  • Phone: 714-577-2652
  • Fax: 714-243-4626
Mailing address:
  • Phone: 714-577-2652
  • Fax: 714-243-4626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number20A14576
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: