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General NPI Number Information
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NPI Number | 1275866238
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Entity Type | Organization
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Legal Business Name | SCHMID PSYCHIATRIC MEDICAL CORPORATION
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Dates
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Enumeration Date | 09/09/2009
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Last Update Date | 09/09/2009
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Provider Practice Location Address
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Address Line | 428 HARRISON AVE SUITE 101
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City | CLAREMONT
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State | CA
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Zip | 91711-4605
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Country | US
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Telephone | 909-624-2160
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Fax | 909-625-5608
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Provider Business Mailing Address
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Address Line | 428 HARRISON AVE SUITE 101
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City | CLAREMONT
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State | CA
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Zip | 91711-4605
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Country | US
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Telephone | 909-624-2160
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Fax | 909-625-5608
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Authorized Official
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Title or Position | OWNER
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Name | LISA PHILLIPS SCHMID
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Credential | M.D.
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Telephone | 909-624-2160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G79451
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License Number State | CA
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