Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 51374 | CA |
NPI | 1043301534 |
---|---|
Provider Name | Dr. Brian James Schabel |
First Address | Santa Cruz, CA 95062-5458 |
Second Address | Santa Cruz, CA 95060-4137 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 08/07/2007 |