Provider Demographics
NPI:1114994985
Name:SCHWARTZ, JOHN THEODORE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:THEODORE
Last Name:SCHWARTZ
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:J.
Other - Middle Name:THEODORE
Other - Last Name:SCHWARTZ
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 31396
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-8396
Mailing Address - Country:US
Mailing Address - Phone:925-939-8585
Mailing Address - Fax:925-933-2709
Practice Address - Street 1:5801 NORRIS CANYON RD
Practice Address - Street 2:SUITE 210
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-5440
Practice Address - Country:US
Practice Address - Phone:925-355-7350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG68871207XS0106X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G688710OtherBLUE SHIELD
CA200008386OtherRAIL ROAD MEDICARE
CA00G688710Medicare PIN
CAE01969Medicare UPIN