Provider Demographics
NPI:1659395051
Name:SCHNEIDER, SCOTT D (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:SCHNEIDER
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:PO BOX 9002
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927
Mailing Address - Country:US
Mailing Address - Phone:530-342-8200
Mailing Address - Fax:530-342-8282
Practice Address - Street 1:251 COHASSET RD
Practice Address - Street 2:SUITE # 320
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2241
Practice Address - Country:US
Practice Address - Phone:530-342-8200
Practice Address - Fax:530-342-8282
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA69327208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A693270Medicaid
G98018Medicare UPIN
CA00A693270Medicaid