MEDICARE: DR. JOHANN JOSUE SCHLAGER OD

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	152WV0400X	Vision Therapy Optometrist	34586	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	:	1255986014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHANN JOSUE SCHLAGER OD

Provider Business Mailing Address
First Line	:	105 SPROUL CT
Second Line	:
City	:	MERCED
State	:	CA
Zip	:	95348-8564
Country	:	US
Telephone Number	:	310-483-6282
Fax Number	:

Provider Business Practice Location Address
First Line	:	3178 COLLINS DR
Second Line	:	STE A
City	:	MERCED
State	:	CA
Zip	:	95348-3155
Country	:	US
Telephone Number	:	209-383-1246
Fax Number	:

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

Provider Enumeration Date	:	08/07/2019
Last Update Date	:	09/09/2021

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