Provider Demographics
NPI:1407873128
Name:SCHMUEL, SCHLOMO (DPM)
Entity Type:Individual
Prefix:
First Name:SCHLOMO
Middle Name:
Last Name:SCHMUEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3367 W 1ST ST
Mailing Address - Street 2:STE 204
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90004-6080
Mailing Address - Country:US
Mailing Address - Phone:213-483-4246
Mailing Address - Fax:213-483-7257
Practice Address - Street 1:2711 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90026-2101
Practice Address - Country:US
Practice Address - Phone:213-483-4246
Practice Address - Fax:213-483-7257
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3848213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E38480Medicaid
CAE3848Medicare ID - Type Unspecified
CA000E38480Medicaid
CA1057540001Medicare NSC