1790778504 NPI number — SUZANNE E SCHAWLB D.O

Table of content: SUZANNE E SCHAWLB D.O (NPI 1790778504)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790778504 NPI number — SUZANNE E SCHAWLB D.O

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHAWLB
Provider First Name:
SUZANNE
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790778504
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/29/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6000 N FIGUEROA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90042-4232
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
323-254-5221
Provider Business Mailing Address Fax Number:
323-254-4618

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
303 LOMA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90017-1103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
213-201-5800
Provider Business Practice Location Address Fax Number:
323-201-5840
Provider Enumeration Date:
08/26/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  20A8487 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207Q00000X , with the licence number: 5560 , registered in the state of AK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)