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General NPI Number Information
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NPI Number | 1245300268
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Entity Type | Individual
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Provider Name | BERT B SCHOENKERMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 12/12/2011
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Provider Practice Location Address
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Address Line | 2100 LYNN RD STE 120
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-8033
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Country | US
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Telephone | 805-495-2161
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Fax | 805-371-1158
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Provider Business Mailing Address
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Address Line | 2100 LYNN RD STE 120
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-8033
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Country | US
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Telephone | 805-495-2161
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Fax | 805-371-1158
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G21861
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207VC0200X
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Taxonomy Name | Critical Care Medicine (Obstetrics & Gynecology) Physician
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License Number | G21861
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | G21861
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | G21861
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | G21861
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License Number State | CA
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