Provider Demographics
NPI:1811918741
Name:SCHOOLER, WESLEY GORDON (MD)
Entity type:Individual
Prefix:
First Name:WESLEY
Middle Name:GORDON
Last Name:SCHOOLER
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 1:427 W PUEBLO ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-6206
Mailing Address - Country:US
Mailing Address - Phone:805-687-7336
Mailing Address - Fax:805-687-9491
Practice Address - Street 1:427 W PUEBLO ST
Practice Address - Street 2:SUITE A
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-6206
Practice Address - Country:US
Practice Address - Phone:805-687-7336
Practice Address - Fax:805-687-9491
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2012-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83721208200000X, 208600000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1811918741Medicaid
CA00A837210OtherBLUE SHIELD PROV. NUMBER
CA00A837210Medicaid
CA1811918741Medicaid
CAWA83721AMedicare PIN