Provider Demographics
NPI:1972737591
Name:SCHAINUCK, LEWIS ISAAC (MD)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:ISAAC
Last Name:SCHAINUCK
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 1:2900 OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-3233
Mailing Address - Country:US
Mailing Address - Phone:949-723-1146
Mailing Address - Fax:949-723-1251
Practice Address - Street 1:2900 OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:CORONA DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92625-3233
Practice Address - Country:US
Practice Address - Phone:949-723-1146
Practice Address - Fax:949-723-1251
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGFE15428174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist