Provider Demographics
NPI:1255634747
Name:SCHOENFELD, EUGENE L (MD)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:L
Last Name:SCHOENFELD
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 1:1368 LINCOLN AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-2121
Mailing Address - Country:US
Mailing Address - Phone:415-331-6832
Mailing Address - Fax:415-331-9513
Practice Address - Street 1:1368 LINCOLN AVE STE 207
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-2121
Practice Address - Country:US
Practice Address - Phone:415-331-6832
Practice Address - Fax:415-331-9513
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-06
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC243332084A0401X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine