Provider Demographics
NPI:1407818115
Name:SCHWARZMAN, PHILIP SIMON (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:SIMON
Last Name:SCHWARZMAN
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 80116
Mailing Address - Street 2:
Mailing Address - City:CITY OF INDUSTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91716-8116
Mailing Address - Country:US
Mailing Address - Phone:800-749-4560
Mailing Address - Fax:405-751-3183
Practice Address - Street 1:501 S BUENA VISTA ST
Practice Address - Street 2:EM DEPT
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4809
Practice Address - Country:US
Practice Address - Phone:818-843-5111
Practice Address - Fax:405-751-3183
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG29911207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00G299110OtherBLUE SHIELD
CA00G299110Medicaid
G29911OtherBLUE CROSS
010039636OtherRAILROAD MEDICARE
G29911OtherBLUE CROSS
WG29911AMedicare PIN