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General NPI Number Information
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NPI Number | 1336897040
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Entity Type | Individual
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Provider Name | JACOB SCHWARTZ PA-C
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Gender | Male
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Dates
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Enumeration Date | 03/11/2022
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Last Update Date | 03/11/2022
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Provider Practice Location Address
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Address Line | 14860 ROSCOE BLVD STE 200
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City | PANORAMA CITY
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State | CA
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Zip | 91402-4683
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Country | US
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Telephone | 310-553-5203
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Fax |
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Provider Business Mailing Address
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Address Line | 12665 VILLAGE LN APT 2301
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City | PLAYA VISTA
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State | CA
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Zip | 90094-2832
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Country | US
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Telephone |
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | PA60894
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | PA60894
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 60894
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License Number State | CA
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