Provider Demographics
NPI:1760552533
Name:SCHACHTSCHNEIDER, BODO (DC)
Entity Type:Individual
Prefix:DR
First Name:BODO
Middle Name:
Last Name:SCHACHTSCHNEIDER
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 1:640 GRAND AVE STE G
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2365
Mailing Address - Country:US
Mailing Address - Phone:760-434-1756
Mailing Address - Fax:
Practice Address - Street 1:640 GRAND AVE STE G
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2365
Practice Address - Country:US
Practice Address - Phone:760-434-1756
Practice Address - Fax:760-434-2482
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC17868111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA262455703OtherEIN
CA262455703OtherEIN