Provider Demographics
NPI:1104992023
Name:SCHWARTZ, MARTIN (MD OB GYN)
Entity type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD OB GYN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 THIRD STREET
Mailing Address - Street 2:SUITE E
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901
Mailing Address - Country:US
Mailing Address - Phone:415-499-4030
Mailing Address - Fax:415-507-2634
Practice Address - Street 1:361 THIRD STREET
Practice Address - Street 2:SUITE E
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901
Practice Address - Country:US
Practice Address - Phone:415-499-4030
Practice Address - Fax:415-507-2634
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG7945207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology