Healthcare Provider Details

I. General information

NPI: 1457459109
Provider Name (Legal Business Name): RICHARD MELVYN SCHILLER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 12/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

#3 6TH STREET
POINT REYES STATION CA
94956-0910
US

IV. Provider business mailing address

PO BOX 910
POINT REYES STATION CA
94956-0910
US

V. Phone/Fax

Practice location:
  • Phone: 415-663-8666
  • Fax: 415-663-9532
Mailing address:
  • Phone: 415-663-8666
  • Fax: 415-663-9532

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE1518
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: