Provider Demographics
NPI:1134313075
Name:MARTIN S SCHNEIDER
Entity Type:Organization
Organization Name:MARTIN S SCHNEIDER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:805-987-2400
Mailing Address - Street 1:2460 LAS POSAS RD STE B
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-3449
Mailing Address - Country:US
Mailing Address - Phone:805-987-2400
Mailing Address - Fax:805-389-6692
Practice Address - Street 1:2460 LAS POSAS RD STE B
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-3449
Practice Address - Country:US
Practice Address - Phone:805-987-2400
Practice Address - Fax:805-389-6692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0186180001Medicare NSC
CAWY4055Medicare PIN