MEDICARE: LARRY SCHELLENBERG RCP

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	2279P1006X	Pulmonary Function Technologist Registered Respiratory Therapist	00009187	CA

General Provider Information

NPI Number	:	1376864454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY SCHELLENBERG RCP

Provider Business Mailing Address
First Line	:	4727 CHICKASAW CT
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-2841
Country	:	US
Telephone Number	:	858-483-3507
Fax Number	:

Provider Business Practice Location Address
First Line	:	4727 CHICKASAW CT
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-2841
Country	:	US
Telephone Number	:	858-483-3507
Fax Number	:

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

Provider Enumeration Date	:	06/12/2010
Last Update Date	:	06/12/2010

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