Provider Demographics
NPI:1588799118
Name:SCHWARTZ, STEPHEN ANDREW (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ANDREW
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:S
Other - Middle Name:ANDREW
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:100 UCLA MEDICAL PLZ
Mailing Address - Street 2:755
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-6970
Mailing Address - Country:US
Mailing Address - Phone:310-825-2278
Mailing Address - Fax:
Practice Address - Street 1:100 UCLA MEDICAL PLZ
Practice Address - Street 2:755
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-6970
Practice Address - Country:US
Practice Address - Phone:310-825-2278
Practice Address - Fax:310-825-3244
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC35757174400000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C357570Medicaid
CA00C357570Medicaid