Provider Demographics
NPI:1851363741
Name:SCHVARTZMAN, JAIME (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:
Last Name:SCHVARTZMAN
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:BOX 5010
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-0735
Mailing Address - Country:US
Mailing Address - Phone:626-915-5181
Mailing Address - Fax:626-331-2313
Practice Address - Street 1:414 E SAN BERNARDINO RD
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1704
Practice Address - Country:US
Practice Address - Phone:626-915-5181
Practice Address - Fax:626-331-2313
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA245602085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A245600Medicaid
CAA24027Medicare UPIN
CAWA24560DMedicare PIN
CA00A245600Medicaid