Provider Demographics
NPI:1740382951
Name:SCHNITZER, MARK S (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:S
Last Name:SCHNITZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 5907
Mailing Address - Street 2:
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90622-9998
Mailing Address - Country:US
Mailing Address - Phone:877-222-0969
Mailing Address - Fax:866-440-4397
Practice Address - Street 1:1400 N HARBOR BLVD
Practice Address - Street 2:540
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835
Practice Address - Country:US
Practice Address - Phone:714-525-7177
Practice Address - Fax:714-525-6769
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA52917207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
F48258Medicare UPIN
CAW13693AMedicare ID - Type Unspecified