Provider Demographics
NPI:1952590382
Name:TSCHIDA, ROBERT J (CPO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:TSCHIDA
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 WATER ST
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-1559
Mailing Address - Country:US
Mailing Address - Phone:831-421-0007
Mailing Address - Fax:831-421-0003
Practice Address - Street 1:1010 WATER ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-1559
Practice Address - Country:US
Practice Address - Phone:831-421-0007
Practice Address - Fax:831-421-0003
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist