Provider Demographics
NPI:1386645083
Name:SCHULTE, DANICA (MD)
Entity Type:Individual
Prefix:
First Name:DANICA
Middle Name:
Last Name:SCHULTE
Suffix:
Gender:F
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 202110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78721-2110
Mailing Address - Country:US
Mailing Address - Phone:512-732-2774
Mailing Address - Fax:855-959-1863
Practice Address - Street 1:16500 VENTURA BLVD
Practice Address - Street 2:SUITE 360
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2011
Practice Address - Country:US
Practice Address - Phone:818-990-9155
Practice Address - Fax:818-990-9167
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2017-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA78964207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I22080Medicare UPIN