MEDICARE: MR. MARCUS ROBERT SCHAIN JR. RDO

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	156FX1800X	Optician	SL5811	CA

General Provider Information

NPI Number	:	1659825149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARCUS ROBERT SCHAIN JR. RDO

Provider Business Mailing Address
First Line	:	4810 E 2ND ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-5312
Country	:	US
Telephone Number	:	562-595-2887
Fax Number	:

Provider Business Practice Location Address
First Line	:	4810 E 2ND ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-5312
Country	:	US
Telephone Number	:	562-595-2887
Fax Number	:

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

Provider Enumeration Date	:	08/12/2016
Last Update Date	:	08/12/2016

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