Provider Demographics
NPI:1689664278
Name:SCHINDLER, MARK (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:SCHINDLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7486 LA JOLLA BLVD
Mailing Address - Street 2:STE 500
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-5029
Mailing Address - Country:US
Mailing Address - Phone:858-488-5554
Mailing Address - Fax:858-488-5545
Practice Address - Street 1:7486 LA JOLLA BLVD
Practice Address - Street 2:STE 500
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-5029
Practice Address - Country:US
Practice Address - Phone:858-488-5554
Practice Address - Fax:858-488-5545
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7815103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP7815Medicare ID - Type UnspecifiedMEDICARE