Provider Demographics
NPI:1285692061
Name:SCHWARTZ, BARRY M (MD)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:M
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:17822 BEACH BLVD STE 367
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-7116
Mailing Address - Country:US
Mailing Address - Phone:714-848-7676
Mailing Address - Fax:714-848-7626
Practice Address - Street 1:17822 BEACH BLVD STE 100
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-7161
Practice Address - Country:US
Practice Address - Phone:714-841-1040
Practice Address - Fax:714-841-1031
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG63587208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000G635870Medicaid
CA000G635870Medicaid
CAE64345Medicare UPIN