Provider Demographics
NPI:1023010030
Name:SCHULTZ, NATHAN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:DAVID
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:130 LA CASA VIA
Mailing Address - Street 2:BLDG 2, STE 209
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3045
Mailing Address - Country:US
Mailing Address - Phone:925-935-6252
Mailing Address - Fax:925-935-7611
Practice Address - Street 1:130 LA CASA VIA
Practice Address - Street 2:BLDG 2, STE 209
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3045
Practice Address - Country:US
Practice Address - Phone:925-935-6252
Practice Address - Fax:925-935-7611
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG21093207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA41175Medicare UPIN