MEDICARE: SUSAN G SCHOR NP

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	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	NP6311	CA

General Provider Information

NPI Number	:	1912106832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN G SCHOR NP

Provider Business Mailing Address
First Line	:	4200 FARM HILL BLVD. BLDG 5-303
Second Line	:	CANADA COLLEGE HEALTH CENTER
City	:	REDWOOD CITY
State	:	CA
Zip	:	94061-1099
Country	:	US
Telephone Number	:	650-306-3129
Fax Number	:	650-306-3185

Provider Business Practice Location Address
First Line	:	4200 FARM HILL BLVD. BLDG 5-303
Second Line	:	CANADA COLLEGE HEALTH CENTER
City	:	REDWOOD CITY
State	:	CA
Zip	:	94061-1099
Country	:	US
Telephone Number	:	650-306-3129
Fax Number	:	650-306-3185

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

Provider Enumeration Date	:	07/11/2007
Last Update Date	:	07/21/2022

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