Healthcare Provider Details

I. General information

NPI: 1922069475
Provider Name (Legal Business Name): PETER A SCHNEIDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 09/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 CAMINO ENCINAS
ORINDA CA
94563-3304
US

IV. Provider business mailing address

9 SLEEPY HOLLOW LN
ORINDA CA
94563-1320
US

V. Phone/Fax

Practice location:
  • Phone: 510-204-8189
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberG51425
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: