Provider Demographics
NPI:1699726612
Name:SCHALL, STEPHEN P (MD)
Entity type:Individual
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First Name:STEPHEN
Middle Name:P
Last Name:SCHALL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:420 E 3RD ST STE 603
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013-1645
Mailing Address - Country:US
Mailing Address - Phone:213-625-2694
Mailing Address - Fax:213-712-7023
Practice Address - Street 1:9100 WILSHIRE BLVD STE 852W
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3464
Practice Address - Country:US
Practice Address - Phone:310-273-3011
Practice Address - Fax:310-273-4829
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2020-09-11
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Provider Licenses
StateLicense IDTaxonomies
CAG39737207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G397371Medicaid
CA00G397371Medicaid
WG39737AMedicare ID - Type Unspecified