MEDICARE: DR. MICHAEL S SCHORR 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	261QP2300X	Primary Care Clinic/Center	G44829	CA
2	208D00000X	General Practice Physician	G44829	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G44829	OTHER	CA	MEDICAL LICENSE

General Provider Information

NPI Number	:	1508922089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL S SCHORR M.D.

Provider Business Mailing Address
First Line	:	101 N 3RD ST
Second Line	:
City	:	PATTERSON
State	:	CA
Zip	:	95363-2501
Country	:	US
Telephone Number	:	209-892-1400
Fax Number	:	209-892-7993

Provider Business Practice Location Address
First Line	:	101 N 3RD ST
Second Line	:
City	:	PATTERSON
State	:	CA
Zip	:	95363-2501
Country	:	US
Telephone Number	:	209-892-1400
Fax Number	:

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

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	03/13/2015

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