Provider Demographics
NPI:1215009188
Name:SCHELBERT, HEINRICH RUDIGER (MD)
Entity Type:Individual
Prefix:DR
First Name:HEINRICH
Middle Name:RUDIGER
Last Name:SCHELBERT
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 1:412 MOUNT HOLYOKE AVE
Mailing Address - Street 2:
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-4603
Mailing Address - Country:US
Mailing Address - Phone:310-825-3076
Mailing Address - Fax:310-267-2677
Practice Address - Street 1:10833 LE CONTE AVE AR105 CHS
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90085
Practice Address - Country:US
Practice Address - Phone:310-794-9513
Practice Address - Fax:310-267-2538
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA29732207UN0903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0903XAllopathic & Osteopathic PhysiciansNuclear MedicineIn Vivo & In Vitro Nuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A297320Medicaid
CAWA29732DMedicare ID - Type Unspecified
CAE84949Medicare UPIN