Provider Demographics
NPI:1356452262
Name:SCHUSTER, RONALD D (DC)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:D
Last Name:SCHUSTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 N CLOVERDALE BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:CLOVERDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95425
Mailing Address - Country:US
Mailing Address - Phone:707-894-3608
Mailing Address - Fax:707-894-2295
Practice Address - Street 1:240 N CLOVERDALE BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:CLOVERDALE
Practice Address - State:CA
Practice Address - Zip Code:95425
Practice Address - Country:US
Practice Address - Phone:707-894-3608
Practice Address - Fax:707-894-2295
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0147520111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2329712Medicaid
T05489Medicare UPIN
CADC0147520Medicare ID - Type Unspecified