Provider Demographics
NPI:1841231537
Name:SCHOONMAKER, JOHN LESLIE (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LESLIE
Last Name:SCHOONMAKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:LESLIE
Other - Last Name:SCHOONMAKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:1545 W FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-3814
Mailing Address - Country:US
Mailing Address - Phone:951-791-1111
Mailing Address - Fax:951-925-3606
Practice Address - Street 1:29826 HAUN RD STE 300
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92586-6547
Practice Address - Country:US
Practice Address - Phone:951-679-7022
Practice Address - Fax:888-379-6223
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A7169207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH19084Medicare UPIN
CAH19084Medicare UPIN