Provider Demographics
NPI:1598838260
Name:MICHAEL S SCHWARTZMD A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:MICHAEL S SCHWARTZMD A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:OURSHEVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-793-5134
Mailing Address - Street 1:960 E GREEN ST
Mailing Address - Street 2:#101
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2401
Mailing Address - Country:US
Mailing Address - Phone:626-793-5134
Mailing Address - Fax:626-793-2912
Practice Address - Street 1:960 E GREEN ST
Practice Address - Street 2:#101
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2401
Practice Address - Country:US
Practice Address - Phone:626-793-5134
Practice Address - Fax:626-793-2912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG50895207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG50895AMedicare ID - Type Unspecified
CAE36031Medicare UPIN