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General NPI Number Information
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NPI Number | 1063632636
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Entity Type | Individual
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Provider Name | DIANE L. SCHNEIDER M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 10/14/2011
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Provider Practice Location Address
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Address Line | 5517 TAFT AVE
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City | LA JOLLA
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State | CA
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Zip | 92037-7643
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Country | US
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Telephone | 858-220-0469
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Fax | 270-518-7275
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Provider Business Mailing Address
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Address Line | 4012 S RAINBOW BLVD K168
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City | LAS VEGAS
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State | NV
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Zip | 89103-2010
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | G68552
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License Number State | CA
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