Provider Demographics
NPI:1720180466
Name:SCHNEIDER, MARTIN STEVEN (OD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:STEVEN
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:MARTY
Other - Middle Name:
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2380 LAS POSAS RD # C
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-3456
Mailing Address - Country:US
Mailing Address - Phone:805-987-2400
Mailing Address - Fax:805-389-6692
Practice Address - Street 1:2380 LAS POSAS RD # C
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-3456
Practice Address - Country:US
Practice Address - Phone:805-987-2400
Practice Address - Fax:805-389-6692
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8582T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWOP8582AMedicare PIN
U18399Medicare UPIN