Provider Demographics
NPI:1346367844
Name:SCHWARTZ, GEORGIA GRACE (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGIA
Middle Name:GRACE
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1801 E COTATI AVE
Mailing Address - Street 2:STUDENT HEALTH CENTER
Mailing Address - City:ROHNERT PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94928-3613
Mailing Address - Country:US
Mailing Address - Phone:707-664-2921
Mailing Address - Fax:707-664-2925
Practice Address - Street 1:1801 E COTATI AVE
Practice Address - Street 2:STUDENT HEALTH CENTER
Practice Address - City:ROHNERT PARK
Practice Address - State:CA
Practice Address - Zip Code:94928-3613
Practice Address - Country:US
Practice Address - Phone:707-664-2921
Practice Address - Fax:707-664-2925
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG-220072080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG-22007OtherLICENSE NUMBER