Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | G057407 | CA |
NPI | 1164540266 |
---|---|
Provider Name | Dr. Charles Schwarz |
First Address | Los Angeles, CA 90025 |
Second Address | Los Angeles, CA 90025-1007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 08/07/2007 |