Provider Demographics
NPI:1437120508
Name:SCHULLER, JOERG (MD)
Entity type:Individual
Prefix:DR
First Name:JOERG
Middle Name:
Last Name:SCHULLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3181 COLLINS DR STE B
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-3113
Mailing Address - Country:US
Mailing Address - Phone:209-580-5767
Mailing Address - Fax:209-697-6454
Practice Address - Street 1:3181 COLLINS DR STE B
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-3113
Practice Address - Country:US
Practice Address - Phone:209-580-5767
Practice Address - Fax:209-697-6454
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60661207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ77315ZOtherMEDI-CAL CALIFORNIA
CA080181578OtherRAILROAD MEDICARE
CA080181578OtherRAILROAD MEDICARE
CAZZZ77315ZOtherMEDI-CAL CALIFORNIA
CA0323680001Medicare NSC