Provider Demographics
NPI:1114202694
Name:SCHOR, EDWARD L (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:L
Last Name:SCHOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 HAMILTON AVE
Mailing Address - Street 2:SUITE 340
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-1833
Mailing Address - Country:US
Mailing Address - Phone:650-736-2663
Mailing Address - Fax:
Practice Address - Street 1:400 HAMILTON AVE
Practice Address - Street 2:SUITE 340
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-1833
Practice Address - Country:US
Practice Address - Phone:650-736-2663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC36651208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics