DR. WALLACE JACK SCHWAM (NPI# 1902144694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902144694 |
| Entity Type | Individual |
| Full Name | DR. WALLACE JACK SCHWAM |
| Credential | M.D. |
| Practice Address |
210 Indio Dr Pismo Beach CA 93449-1514 |
| Mailing Address |
Po Box 1158 Solvang CA 93464-1158 |
| Practice Telephone | 8052318699 |
| Mailing Telephone | 8052318699 |
| Enumeration Date | 2013-01-30 |
| Last Update Date | 2013-01-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
GFE12267 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
210 INDIO DR |
| City | PISMO BEACH |
| State | CA |
| Zip Code | 93449-1514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831688795 | Kristyn Collins | Psychologist | 130 James Way, #150, Pismo Beach, CA 93449 | 2018-05-07 |
| 1245750140 | Judy Burke Morabito | Pedorthist | 801 Dolliver Street, Pismo Beach, CA 93449 | 2017-06-21 |
| 1295274413 | The San Luis Obispo Hearing Center, Inc | Specialist | 901 Oak Park Blvd Suite 202, Pismo Beach, CA 93449 | 2017-02-21 |
| 1649713645 | Sarah Victoria Stroemel | Counselor | 172 Stimson Ave, #3, Pismo Beach, CA 93449 | 2016-11-22 |
| 1497133631 | Byron N Collier | Podiatrist | 911 Oak Park Blvd Ste 106, Pismo Beach, CA 93449 | 2015-05-07 |
| 1982973319 | Mariana Dintyala | Nurse Practitioner | Avery Healthcare Sevices, 230 Coral Ct, Pismo Beach, CA 93449 | 2011-12-13 |
| 1538444575 | Chelsea Hunter | Student in an Organized Health Care Education/Training Program | 448 Foothill Rd, Pismo Beach, CA 93449 | 2011-10-20 |
| 1952621492 | Briana Leigh Schiro | Counselor | 314 El Portal Dr., Suite 100, Pismo Beach, CA 93449 | 2010-06-07 |
| 1134365315 | Robert Lee Hix | Licensed Psychiatric Technician | 201 Five Cities Dr., 123, Pismo Beach, CA 93449 | 2008-12-18 |
| 1689886764 | Active Physical Therapy Inc | Physical Therapist | 1851 Shell Beach Rd, Suite B, Shell Beach, CA 93449 | 2007-05-03 |
| Find all providers in zip 93449 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902421480 | Healthier Lifestyle Medical Group | Internal Medicine | 1412 W Glenoaks Blvd Ste B, Glendale, CA 91201-1990 | 2020-06-10 |
| 1972065704 | Joseph A Habis Md | Internal Medicine | 359 Bel Marin Keys Blvd Ste 22, Novato, CA 94949-5637 | 2019-04-01 |
| 1801363858 | Hgrt Medical Group Inc | Internal Medicine | 31741 Rancho Hill Viejo Road, San Juan Capistrano, CA 92675 | 2018-10-29 |
| 1972081412 | Ahra Cho, M.d., Inc | Internal Medicine | 2727 W Olympic Blvd Ste 205, Los Angeles, CA 90006-2640 | 2018-08-06 |
| 1013401975 | Robert H Moon Md, Inc | Internal Medicine | 181 Rea Ave, El Cajon, CA 92020-3985 | 2018-06-14 |
| 1821587585 | Aost Healthcare Services | Internal Medicine | 10990 Lower Azusa Rd Ste 4, El Monte, CA 91731-1353 | 2018-05-08 |
| 1396233185 | Caroline Petrossian | Internal Medicine | 1880 Century Park East Suite 711, Century City, CA 90067 | 2018-04-26 |
| 1558868927 | Gps Physician Group of California PC | Internal Medicine | American River Center, 3900 Garfield Ave, Carmichael, CA 95608 | 2018-04-11 |
| 1427588417 | Vivacitas Medical Group PC | Internal Medicine | 1383 N Mcdowell Blvd Ste 110, Petaluma, CA 94954-1190 | 2017-06-13 |
| 1144616590 | Lindsey Merrihew Haddock | Internal Medicine | 4150 Clement St Bldg 1306b, San Francisco, CA 94121 | 2015-04-13 |
| Find all providers with the same taxonomy | ||||
| City | PISMO BEACH |
| Zip Code | 93449 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.