MEDICARE: JESSICA LYNN SCHNEIDER M.D.

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	207V00000X	Obstetrics & Gynecology Physician	A67526	CA

General Provider Information

NPI Number	:	1063419273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA LYNN SCHNEIDER M.D.

Provider Business Mailing Address
First Line	:	8631 W 3RD ST
Second Line	:	SUITE 510E
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5901
Country	:	US
Telephone Number	:	310-659-9104
Fax Number	:	310-659-3049

Provider Business Practice Location Address
First Line	:	10309 SANTA MONICA BLVD
Second Line	:	# 300
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5007
Country	:	US
Telephone Number	:	310-557-3766
Fax Number	:	310-282-8567

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

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	04/28/2011

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