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General NPI Number Information
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NPI Number | 1376549022
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Entity Type | Individual
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Provider Name | MARY THERESA SCHUH-CLARK DPM
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Gender | Female
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Dates
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Enumeration Date | 06/27/2005
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 1990 WESTWOOD BLVD STE 220
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City | LOS ANGELES
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State | CA
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Zip | 90025-4674
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Country | US
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Telephone | 310-475-5377
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Fax | 310-446-1825
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Provider Business Mailing Address
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Address Line | 1990 WESTWOOD BLVD STE 220
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City | LOS ANGELES
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State | CA
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Zip | 90025-4674
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Country | US
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Telephone | 310-475-5377
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E5996
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | E5996
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | E5996
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License Number State | CA
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