Provider Demographics
NPI:1891895702
Name:SCHWARTZ, RONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
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 1:21700 GOLDEN TRIANGLE RD
Mailing Address - Street 2:102
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-2616
Mailing Address - Country:US
Mailing Address - Phone:661-260-1155
Mailing Address - Fax:661-260-1192
Practice Address - Street 1:21700 GOLDEN TRIANGLE RD
Practice Address - Street 2:102
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-2616
Practice Address - Country:US
Practice Address - Phone:661-260-1155
Practice Address - Fax:661-260-1192
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39334208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A393342Medicaid
CA010024452OtherRAIL ROAD MEDICARE
CAA85275Medicare UPIN
CA010024452OtherRAIL ROAD MEDICARE