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NPI Code Detail

MEDICARE: MR. MARTIN JAMES SCHNECKENBERGER PT

MEDICARE: MR. MARTIN JAMES SCHNECKENBERGER PT
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
1225100000XPhysical TherapistPT 24463CA

General Provider Information

NPI Number : 1972621126
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARTIN JAMES SCHNECKENBERGER PT
Provider Business Mailing Address
First Line : 5619 GARYPARK AVE
Second Line :
City : ARCADIA
State : CA
Zip : 91006-5727
Country : US
Telephone Number : 626-444-5465
Fax Number :
Provider Business Practice Location Address
First Line : 120 N ROBERTSON BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90048-3115
Country : US
Telephone Number : 310-854-5949
Fax Number : 310-854-6049
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2007
Last Update Date : 07/08/2007

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Directions to “ MR. MARTIN JAMES SCHNECKENBERGER PT” Practice Location

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