Provider Demographics
NPI:1750553020
Name:PACIFIC GYNECOLOGIC SPECIALISTS
Entity type:Organization
Organization Name:PACIFIC GYNECOLOGIC SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCHLAERTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-932-7974
Mailing Address - Street 1:PO BOX 49092
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95161-9092
Mailing Address - Country:US
Mailing Address - Phone:661-932-7974
Mailing Address - Fax:661-326-1411
Practice Address - Street 1:2011 19TH ST
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:661-932-7974
Practice Address - Fax:661-326-1411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG18591207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0103812Medicaid
CA00G185910Medicaid
CAWG18591CMedicare Oscar/Certification