Healthcare Provider Details

I. General information

NPI: 1174591259
Provider Name (Legal Business Name): COMMUNITY MEDICAL GROUP OF DOWNEY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 03/17/2020
Certification Date: 03/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10800 PARAMOUNT BLVD SUITE 402
DOWNEY CA
90241-3331
US

IV. Provider business mailing address

10800 PARAMOUNT BLVD SUITE 402
DOWNEY CA
90241-3331
US

V. Phone/Fax

Practice location:
  • Phone: 562-923-8333
  • Fax: 562-923-2433
Mailing address:
  • Phone: 562-904-4411
  • Fax: 562-904-4415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A4199
License Number StateCA

VIII. Authorized Official

Name: MARK DAVID SCHNEIDER
Title or Position: PRESIDENT/PROVIDER
Credential: D.O.
Phone: 562-904-4411