1851435374 NPI number — DR. ANNE RYBACK SCHMIDT M.D.

Table of content: DR. ANNE RYBACK SCHMIDT M.D. (NPI 1851435374)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851435374 NPI number — DR. ANNE RYBACK SCHMIDT M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHMIDT
Provider First Name:
ANNE
Provider Middle Name:
RYBACK
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1851435374
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2428 SANTA MONICA BLVD
Provider Second Line Business Mailing Address:
SUITE 301
Provider Business Mailing Address City Name:
SANTA MONICA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90404-2045
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-828-6235
Provider Business Mailing Address Fax Number:
310-828-0158

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2428 SANTA MONICA BLVD
Provider Second Line Business Practice Location Address:
SUITE 301
Provider Business Practice Location Address City Name:
SANTA MONICA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90404-2045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-828-6235
Provider Business Practice Location Address Fax Number:
310-828-0158
Provider Enumeration Date:
02/17/2007

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: 261QM2500X , with the licence number:  A043508 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: A043508 . This is a "STATE LICENSE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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