MEDICARE: DR. MYRON P. SCHNEIDER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	A25603	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023013125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MYRON P. SCHNEIDER MD

Provider Business Mailing Address
First Line	:	PO BOX 3222
Second Line	:	DEPT OF IMAGING
City	:	NAPA
State	:	CA
Zip	:	94558-0293
Country	:	US
Telephone Number	:	707-261-7822
Fax Number	:	707-256-3508

Provider Business Practice Location Address
First Line	:	5176 HILL RD E
Second Line	:	DEPT OF IMAGING
City	:	LAKEPORT
State	:	CA
Zip	:	95453-6300
Country	:	US
Telephone Number	:	707-262-5035
Fax Number	:	707-256-3508

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	03/12/2014

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