Provider Demographics
NPI:1629070313
Name:SCHNEIDER, BRUCE JOSEPH (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:JOSEPH
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 ALMOND TREE LN
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2230
Mailing Address - Country:US
Mailing Address - Phone:949-733-9970
Mailing Address - Fax:949-786-6270
Practice Address - Street 1:21 ALMOND TREE LN
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2230
Practice Address - Country:US
Practice Address - Phone:949-733-9970
Practice Address - Fax:949-786-6270
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2344213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0000E2344Medicare ID - Type UnspecifiedMEDICARE PROVIDER #