Provider Demographics
NPI:1194879767
Name:SCHWAB, SARAH C (LAC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:C
Last Name:SCHWAB
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7251 WILLOUGHBY AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-6744
Mailing Address - Country:US
Mailing Address - Phone:323-627-7697
Mailing Address - Fax:
Practice Address - Street 1:1041 N FORMOSA AVE
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-6703
Practice Address - Country:US
Practice Address - Phone:323-627-7697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11419171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist