Provider Demographics
NPI:1306225446
Name:SCHOONOVER, GARY
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:
Last Name:SCHOONOVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 HERNDON AVE # K356
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-6163
Mailing Address - Country:US
Mailing Address - Phone:559-765-2020
Mailing Address - Fax:188-871-5170
Practice Address - Street 1:1865 HERNDON AVE # K356
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-6163
Practice Address - Country:US
Practice Address - Phone:559-765-2020
Practice Address - Fax:188-871-5170
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies