Provider Demographics
NPI:1942360755
Name:SCHNITMAN, J RANDOLPH (MD)
Entity Type:Individual
Prefix:
First Name:J
Middle Name:RANDOLPH
Last Name:SCHNITMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:435 NORTH BEDFORD DRIVE
Mailing Address - Street 2:LOWER LEVEL 1
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210
Mailing Address - Country:US
Mailing Address - Phone:310-275-5432
Mailing Address - Fax:310-275-5434
Practice Address - Street 1:435 N BEDFORD DR
Practice Address - Street 2:LOWER LEVEL 1
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4321
Practice Address - Country:US
Practice Address - Phone:310-275-5432
Practice Address - Fax:310-275-5434
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG62430207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery