Provider Demographics
NPI:1841239365
Name:SCHNEIDER, ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 OSAGE AVE.
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022
Mailing Address - Country:US
Mailing Address - Phone:408-358-6881
Mailing Address - Fax:408-358-7120
Practice Address - Street 1:200 OSAGE AVE.
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022
Practice Address - Country:US
Practice Address - Phone:408-358-6881
Practice Address - Fax:408-358-7120
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA434502085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
300028098OtherRAILROAD MEDICARE PIN
CA00A434500Medicaid
300028098OtherRAILROAD MEDICARE PIN
E25309Medicare UPIN