Provider Demographics
NPI:1972653616
Name:SCHOBERT, WILLIAM E
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:E
Last Name:SCHOBERT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26010 ACERO
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-2799
Mailing Address - Country:US
Mailing Address - Phone:949-768-5000
Mailing Address - Fax:949-768-5001
Practice Address - Street 1:26010 ACERO
Practice Address - Street 2:SUITE 100
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-2799
Practice Address - Country:US
Practice Address - Phone:949-768-5000
Practice Address - Fax:949-768-5001
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG039739174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG039739OtherSTATE MEDICAL LICENSE #
CAG39739Medicare ID - Type Unspecified
CAG039739OtherSTATE MEDICAL LICENSE #