Provider Demographics
NPI:1164755955
Name:SCHULTZ, ANN LOUISE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:LOUISE
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 S FREMONT AVE
Mailing Address - Street 2:BLDG A-11, ROOM 11164
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-8800
Mailing Address - Country:US
Mailing Address - Phone:626-457-4271
Mailing Address - Fax:626-457-4260
Practice Address - Street 1:1000 S FREMONT AVE
Practice Address - Street 2:BLDG 7, 4TH FLOOR, UNIT A6
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-8800
Practice Address - Country:US
Practice Address - Phone:626-457-4271
Practice Address - Fax:626-457-4260
Is Sole Proprietor?:No
Enumeration Date:2009-09-10
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA14492363AM0700X
CA14492363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical