Healthcare Provider Details

I. General information

NPI: 1790768679
Provider Name (Legal Business Name): RUDOLPH J. SCHROT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: RUDOLPH J. SCHROT M.D.

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 06/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 L ST SUITE 500
SACRAMENTO CA
95816-5616
US

IV. Provider business mailing address

10470 OLD PLACERVILLE RD SUITE 100
SACRAMENTO CA
95827-2539
US

V. Phone/Fax

Practice location:
  • Phone: 916-454-6850
  • Fax: 916-454-6852
Mailing address:
  • Phone: 800-470-0071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberA70871
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: