Provider Demographics
NPI:1811049703
Name:JAMES E. SCHWANKE, MD.
Entity type:Organization
Organization Name:JAMES E. SCHWANKE, MD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:FERRIGNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-577-8044
Mailing Address - Street 1:3700 24TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-3904
Mailing Address - Country:US
Mailing Address - Phone:415-641-1019
Mailing Address - Fax:415-826-1308
Practice Address - Street 1:3700 24TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-3904
Practice Address - Country:US
Practice Address - Phone:415-641-1019
Practice Address - Fax:415-826-1308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2011-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG282532080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G282530Medicaid