Provider Demographics
NPI:1134296767
Name:SCHNEIDER, MARK EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:EDWARD
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1124 S MAIN ST
Mailing Address - Street 2:# 101
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92882-4449
Mailing Address - Country:US
Mailing Address - Phone:951-737-6363
Mailing Address - Fax:951-272-6723
Practice Address - Street 1:1124 S MAIN ST
Practice Address - Street 2:# 101
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92882-4449
Practice Address - Country:US
Practice Address - Phone:951-737-6363
Practice Address - Fax:951-272-6723
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2009-03-12
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Provider Licenses
StateLicense IDTaxonomies
CAA41478207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE38301Medicare UPIN
CA00A414781Medicare PIN