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General NPI Number Information
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NPI Number | 1871663021
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Entity Type | Organization
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Legal Business Name | WEBSTER ORTHOPAEDIC MEDICAL GROUP, A PROFESSIONAL CORP.
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 01/16/2017
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Provider Practice Location Address
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Address Line | 200 PORTER DR SUITE 101
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City | SAN RAMON
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State | CA
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Zip | 94583-1587
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Country | US
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Telephone | 925-838-1440
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Fax | 925-838-2481
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Provider Business Mailing Address
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Address Line | 200 PORTER DR SUITE 215
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City | SAN RAMON
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State | CA
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Zip | 94583-1587
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Country | US
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Telephone | 925-838-1440
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Fax | 925-838-2481
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN THEODORE SCHWARTZ JR.
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Credential | M.D.
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Telephone | 925-362-2166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State | CA
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