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General NPI Number Information
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NPI Number | 1215919014
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Entity Type | Individual
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Provider Name | EDWARD SCHNEIDER MD
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Gender | Male
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Dates
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Enumeration Date | 11/17/2005
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Last Update Date | 06/22/2010
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Provider Practice Location Address
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Address Line | 1017 W LINCOLN RD
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City | STOCKTON
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State | CA
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Zip | 95207-2515
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Country | US
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Telephone | 209-951-3945
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Fax | 209-954-9205
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Provider Business Mailing Address
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Address Line | 1017 W LINCOLN RD
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City | STOCKTON
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State | CA
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Zip | 95207-2515
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Country | US
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Telephone | 209-951-3945
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Fax | 209-954-9205
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G20679
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License Number State | CA
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