Provider Demographics
NPI:1659655587
Name:SCHWARTZ, MARVIN HAROLD (MD)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:HAROLD
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 EUREKA CT.
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-5555
Mailing Address - Country:US
Mailing Address - Phone:650-960-3541
Mailing Address - Fax:
Practice Address - Street 1:1220 EUREKA CT.
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-5555
Practice Address - Country:US
Practice Address - Phone:650-960-3541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACFE21226208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology