MEDICARE: DR. SUSAN S. SCHOMMER 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	208600000X	Surgery Physician	35-04-7938	OH
2	208600000X	Surgery Physician	2001-93	NM
3	208600000X	Surgery Physician	C50650	CA
4	208600000X	Surgery Physician	MD-13527EFF	HI
5	208600000X	Surgery Physician	018328	ME
6	208600000X	Surgery Physician	063153	GA

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	:	1962427948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN S. SCHOMMER M.D.

Provider Business Mailing Address
First Line	:	194 SEACLIFF DR
Second Line	:
City	:	SHELL BEACH
State	:	CA
Zip	:	93449-1715
Country	:	US
Telephone Number	:	805-773-1453
Fax Number	:

Provider Business Practice Location Address
First Line	:	194 SEACLIFF DR
Second Line	:
City	:	SHELL BEACH
State	:	CA
Zip	:	93449-1715
Country	:	US
Telephone Number	:	805-773-1453
Fax Number	:

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	12/18/2009

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Directions to “ DR. SUSAN S. SCHOMMER M.D.” Practice Location

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