Provider Demographics
NPI:1265630396
Name:C. ANDREW SCHROEDER M.D., INC.
Entity Type:Organization
Organization Name:C. ANDREW SCHROEDER M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:C. ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-432-4260
Mailing Address - Street 1:9401 WILSHIRE BLVD
Mailing Address - Street 2:SUITE #515
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2928
Mailing Address - Country:US
Mailing Address - Phone:310-432-4260
Mailing Address - Fax:310-432-2015
Practice Address - Street 1:9401 WILSHIRE BLVD
Practice Address - Street 2:SUITE #515
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2928
Practice Address - Country:US
Practice Address - Phone:310-432-4260
Practice Address - Fax:310-432-2015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74826207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI33070OtherUPIN