Provider Demographics
NPI:1780876789
Name:SCHEUCH, WAYNE ELLIOT (MT)
Entity type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:ELLIOT
Last Name:SCHEUCH
Suffix:
Gender:M
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:221 WESTWOOD PLAZA
Mailing Address - Street 2:SUITE 371
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-0001
Mailing Address - Country:US
Mailing Address - Phone:310-206-4120
Mailing Address - Fax:310-206-3070
Practice Address - Street 1:221 WESTWOOD PLAZA
Practice Address - Street 2:SUITE 371
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-206-4120
Practice Address - Fax:310-206-3070
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMTA31629246QL0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QL0900XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyLaboratory Management