Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | A63871 | CA |
NPI | 1003037508 |
---|---|
Provider Name | Dr. Ernest Shmidt |
First Address | Orange, CA 92863-5486 |
Second Address | Los Angeles, CA 90028-8253 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 16/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H66757 | (02) | CA |