Provider Demographics
NPI:1184616872
Name:SCHUMAKER, EDWARD WILLIAM (DO)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:WILLIAM
Last Name:SCHUMAKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:653 EL PORTAL DR
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-4109
Mailing Address - Country:US
Mailing Address - Phone:619-419-1958
Mailing Address - Fax:
Practice Address - Street 1:2452 FENTON ST
Practice Address - Street 2:SUITE 301
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-3599
Practice Address - Country:US
Practice Address - Phone:619-946-4073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6433207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E12338Medicare UPIN