Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | G68871 | CA |
NPI | 1114994985 |
---|---|
Provider Name | Dr. John Theodore Schwartz JR. |
First Address | San Ramon, CA 94583-1587 |
Second Address | San Ramon, CA 94583-5440 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/03/2006 |
Last Update Date | 11/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G688710 | BLUE SHIELD (01) | CA |
200008386 | RAIL ROAD MEDICARE (01) | CA |
E01969 | (02) | CA |