Provider Demographics
NPI:1417152042
Name:SHATZMILLER, RON ANDREW (MD, MSC)
Entity Type:Individual
Prefix:DR
First Name:RON
Middle Name:ANDREW
Last Name:SHATZMILLER
Suffix:
Gender:M
Credentials:MD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 E COLORADO BLVD STE 602
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2015
Mailing Address - Country:US
Mailing Address - Phone:626-765-6704
Mailing Address - Fax:
Practice Address - Street 1:595 E COLORADO BLVD STE 602
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2015
Practice Address - Country:US
Practice Address - Phone:626-765-6704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.2069662084N0400X
CAA1003222084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology