=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275905390
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAREN A SCHULZE DDS, PHD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/28/2015
-----------------------------------------------------
Last Update Date | 10/28/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 155 5TH ST A. A. DUGONI SCHOOL OF DENTISTRY
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94103-2919
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-929-6442
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2525 CALIFORNIA ST APT 301
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94115-2685
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-929-6442
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 51997
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------