MEDICARE: LAURA SCHMEER MPAS, PA-C

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	363A00000X	Physician Assistant	57536	CA

General Provider Information

NPI Number	:	1518504513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA SCHMEER MPAS, PA-C

Provider Business Mailing Address
First Line	:	661 CAMINO ROJO
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-2115
Country	:	US
Telephone Number	:	805-630-2232
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 E DAILY DR STE 228
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-5840
Country	:	US
Telephone Number	:	805-914-0637
Fax Number	:

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

Provider Enumeration Date	:	12/09/2019
Last Update Date	:	12/09/2019

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