Provider Demographics
NPI:1396818720
Name:SCHILLER, DON J (MD)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:J
Last Name:SCHILLER
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 1:9808 VENICE BLVD
Mailing Address - Street 2:STE 603
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-6819
Mailing Address - Country:US
Mailing Address - Phone:310-204-4565
Mailing Address - Fax:310-204-4566
Practice Address - Street 1:9808 VENICE BLVD
Practice Address - Street 2:STE 603
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-6819
Practice Address - Country:US
Practice Address - Phone:310-204-4565
Practice Address - Fax:310-204-4566
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG 22255208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA41523Medicare UPIN