Provider Demographics
NPI:1326083197
Name:SCHUMAKER, HENRY M (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:M
Last Name:SCHUMAKER
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:PO BOX 51092
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90051-5392
Mailing Address - Country:US
Mailing Address - Phone:888-688-2938
Mailing Address - Fax:818-587-2493
Practice Address - Street 1:1223 WILSHIRE BLVD
Practice Address - Street 2:#154
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-5406
Practice Address - Country:US
Practice Address - Phone:310-403-7549
Practice Address - Fax:310-356-4939
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG49796207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G497960OtherBLUE SHIELD
CA00G497960Medicaid
CA00G497960Medicaid
CAWG49796CMedicare ID - Type Unspecified