Provider Demographics
NPI:1699011460
Name:SCHRAUB, ADAM A (PA)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:A
Last Name:SCHRAUB
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:862 MEINECKE AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-3701
Mailing Address - Country:US
Mailing Address - Phone:805-739-3863
Mailing Address - Fax:805-614-2035
Practice Address - Street 1:300 S STRATFORD AVE
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5903
Practice Address - Country:US
Practice Address - Phone:805-739-3863
Practice Address - Fax:805-614-2035
Is Sole Proprietor?:No
Enumeration Date:2012-12-21
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA22722363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant