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General NPI Number Information
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NPI Number | 1679790778
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Entity Type | Organization
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Legal Business Name | BEN SHWACHMAN MD APC
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/17/2007
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Provider Practice Location Address
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Address Line | 315 N 3RD AVE SUITE 200
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City | COVINA
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State | CA
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Zip | 91723-1905
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Country | US
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Telephone | 626-967-3176
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Fax | 626-967-8743
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Provider Business Mailing Address
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Address Line | 315 N 3RD AVE SUITE 200
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City | COVINA
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State | CA
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Zip | 91723-1905
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Country | US
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Telephone | 626-967-3176
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Fax | 626-967-8743
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Authorized Official
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Title or Position | PRESIDENT
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Name | BEN SHWACHMAN
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Credential | MD
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Telephone | 626-967-1606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | G11026
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License Number State | CA
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