MEDICARE: DR. ERNEST SHMIDT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	A63871	CA

General Provider Information

NPI Number	:	1003037508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERNEST SHMIDT MD

Provider Business Mailing Address
First Line	:	PO BOX 5486
Second Line	:
City	:	ORANGE
State	:	CA
Zip	:	92863-5486
Country	:	US
Telephone Number	:	818-550-0900
Fax Number	:	303-953-8260

Provider Business Practice Location Address
First Line	:	6245 DE LONGPRE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-8253
Country	:	US
Telephone Number	:	323-462-2271
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	11/16/2015

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