Provider Demographics
NPI:1336237080
Name:SCHUBERT PALMER, M.D., INC.
Entity Type:Organization
Organization Name:SCHUBERT PALMER, M.D., INC.
Other - Org Name:LOMA LINDA CARDIOLOGY MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HIRAM
Authorized Official - Middle Name:SCHUBERT
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-224-2040
Mailing Address - Street 1:PO BOX 331100
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-0002
Mailing Address - Country:US
Mailing Address - Phone:323-224-2040
Mailing Address - Fax:323-224-2061
Practice Address - Street 1:1701 E CESAR E CHAVEZ AVE
Practice Address - Street 2:SUITE 403
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-2464
Practice Address - Country:US
Practice Address - Phone:323-224-2040
Practice Address - Fax:323-224-2061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACN2872OtherRAILROAD MEDICARE
CAGR0100070Medicaid
CAFNP 24978OtherMED. BOARD FICTITIOUS NAM
CAZZZ66380ZOtherBLUE CROSS/BLUE SHIELD
CAW14113Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER