Provider Demographics
NPI:1346490828
Name:SCHROEDER, STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 DIVISADERO ST
Mailing Address - Street 2:RM A528
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-1211
Mailing Address - Country:US
Mailing Address - Phone:415-502-1881
Mailing Address - Fax:
Practice Address - Street 1:1600 DIVISADERO ST
Practice Address - Street 2:RM A528
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-1211
Practice Address - Country:US
Practice Address - Phone:415-502-1881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG15333207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA39501Medicare UPIN