Provider Demographics
NPI:1457368029
Name:SCHLAERTH, JOHN BURR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:BURR
Last Name:SCHLAERTH
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:P.O. BOX 8410
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91109-8410
Mailing Address - Country:US
Mailing Address - Phone:661-326-1401
Mailing Address - Fax:661-326-1411
Practice Address - Street 1:2011 19TH STREET
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-4211
Practice Address - Country:US
Practice Address - Phone:661-326-1401
Practice Address - Fax:661-326-1411
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG18591207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG185910CMedicare PIN
CAA40373Medicare UPIN