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NPI Code Detail

MEDICARE: ANDREW SCHOENWETTER DTR

MEDICARE:   ANDREW  SCHOENWETTER  DTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1136A00000XRegistered Dietetic Technician00946654CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100946654OTHERCAREGISTRATION NUMBER

General Provider Information

NPI Number : 1548489099
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW SCHOENWETTER DTR
Provider Business Mailing Address
First Line : 989 AILEEN ST
Second Line :
City : OAKLAND
State : CA
Zip : 94608-2841
Country : US
Telephone Number : 510-601-6702
Fax Number :
Provider Business Practice Location Address
First Line : 375 LAGUNA HONDA BLVD
Second Line : LAGUNA HONDA HOSPITAL - NUTRITION SERVICES
City : SAN FRANCISCO
State : CA
Zip : 94116-1411
Country : US
Telephone Number : 415-759-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2007
Last Update Date : 07/08/2007

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Directions to “ ANDREW SCHOENWETTER DTR” Practice Location

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