Provider Demographics
NPI:1801983374
Name:SCHAUWEKER, PHILIP SCOTT (DPM)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:SCOTT
Last Name:SCHAUWEKER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1043 ELM AVE
Mailing Address - Street 2:SUITE 407
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-3271
Mailing Address - Country:US
Mailing Address - Phone:562-491-0505
Mailing Address - Fax:562-491-0525
Practice Address - Street 1:1043 ELM AVE
Practice Address - Street 2:SUITE 407
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-3271
Practice Address - Country:US
Practice Address - Phone:562-491-0505
Practice Address - Fax:562-491-0525
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3911213ER0200X, 213ES0000X, 213ES0103X, 213ES0131X, 213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E39110Medicaid
CAE3911CMedicare ID - Type Unspecified
U47886Medicare UPIN
CA5424490001Medicare NSC