MEDICARE: DR. BRIAN JAMES SCHABEL D.D.S., M.S.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	51374	CA

General Provider Information

NPI Number	:	1043301534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN JAMES SCHABEL D.D.S., M.S.

Provider Business Mailing Address
First Line	:	3221 HAWES DR
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95062-5458
Country	:	US
Telephone Number	:	831-454-8888
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 WATER ST STE L2
Second Line	:
City	:	SANTA CRUZ
State	:	CA
Zip	:	95060-4137
Country	:	US
Telephone Number	:	831-426-4344
Fax Number	:	831-426-5223

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/08/2007

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