Provider Demographics
NPI:1235282088
Name:SCHWARTZ, IRVING J (MD)
Entity Type:Individual
Prefix:
First Name:IRVING
Middle Name:J
Last Name:SCHWARTZ
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 1:450 QUEENS AVE
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-2965
Mailing Address - Country:US
Mailing Address - Phone:530-671-1660
Mailing Address - Fax:
Practice Address - Street 1:450 QUEENS AVE
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-2965
Practice Address - Country:US
Practice Address - Phone:530-671-1660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2024-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37528207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A375280Medicaid
CA00A375280Medicare PIN
CAA37528AMedicare PIN
CA00A375280Medicaid
CAA37528Medicare PIN