Provider Demographics
NPI:1669662508
Name:SCHENLEY L. CO M.D INC.
Entity Type:Organization
Organization Name:SCHENLEY L. CO M.D INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCHENLEY
Authorized Official - Middle Name:LIM
Authorized Official - Last Name:CO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-377-2202
Mailing Address - Street 1:3655 LOMITA BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3968
Mailing Address - Country:US
Mailing Address - Phone:310-377-2202
Mailing Address - Fax:310-377-2409
Practice Address - Street 1:3655 LOMITA BLVD STE 301
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3968
Practice Address - Country:US
Practice Address - Phone:310-377-2202
Practice Address - Fax:310-377-2409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA3723402084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A372340OtherBLUE SHIELD OF CA
CA1619994613OtherINDIVIDUAL NPI NUMBER
CA130001519OtherRAILROAD MEDICARE
CA00A372341OtherMEDI-CAL
CAA84989Medicare UPIN