Provider Demographics
NPI:1497323646
Name:JEREMY SCHWIEGER, M.D., A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:JEREMY SCHWIEGER, M.D., A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWIEGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-400-5594
Mailing Address - Street 1:18840 VENTURA BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3381
Mailing Address - Country:US
Mailing Address - Phone:818-654-8111
Mailing Address - Fax:818-757-1311
Practice Address - Street 1:18840 VENTURA BLVD STE 207
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3381
Practice Address - Country:US
Practice Address - Phone:818-654-8111
Practice Address - Fax:818-757-1311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty