Healthcare Provider Details

I. General information

NPI: 1407867211
Provider Name (Legal Business Name): DAVID JAY SCHNEIDERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 10/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6357 COYLE AVE SUITE A
CARMICHAEL CA
95608-0478
US

IV. Provider business mailing address

6357 COYLE AVE SUITE A
CARMICHAEL CA
95608-0478
US

V. Phone/Fax

Practice location:
  • Phone: 916-863-1000
  • Fax: 916-863-1234
Mailing address:
  • Phone: 916-863-1000
  • Fax: 916-863-1234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberC407820
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: