Provider Demographics
NPI:1386755346
Name:SCHROEDER, C ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:C
Middle Name:ANDREW
Last Name:SCHROEDER
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 1:9401 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 515
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-2928
Mailing Address - Country:US
Mailing Address - Phone:310-432-4260
Mailing Address - Fax:
Practice Address - Street 1:9401 WILSHIRE BLVD
Practice Address - Street 2:SUITE 515
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-2928
Practice Address - Country:US
Practice Address - Phone:310-432-4260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA74826207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA74826AMedicare ID - Type Unspecified
CAI33070Medicare UPIN