Healthcare Provider Details

I. General information

NPI: 1891481644
Provider Name (Legal Business Name): EVAN WILLIAM SCHNEIDER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

890 EASTLAKE PKWY STE 103
CHULA VISTA CA
91914-4521
US

IV. Provider business mailing address

890 EASTLAKE PKWY STE 103
CHULA VISTA CA
91914-4521
US

V. Phone/Fax

Practice location:
  • Phone: 619-353-0184
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE6291
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: