MEDICARE: DR. IVAN ROY SCHWAB M.D.

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	207W00000X	Ophthalmology Physician	G27165	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174508675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IVAN ROY SCHWAB M.D.

Provider Business Mailing Address
First Line	:	4860 Y ST
Second Line	:	SUITE 2400
City	:	SACRAMENTO
State	:	CA
Zip	:	95817-2307
Country	:	US
Telephone Number	:	916-734-6070
Fax Number	:	916-734-6992

Provider Business Practice Location Address
First Line	:	4860 Y ST
Second Line	:	SUITE 2400
City	:	SACRAMENTO
State	:	CA
Zip	:	95817-2307
Country	:	US
Telephone Number	:	916-734-6070
Fax Number	:	916-734-6992

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

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	01/04/2026

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