Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | SC006497 | PA |
NPI | 1023458692 |
---|---|
Provider Name | Dr. Brian Joseph Schneekloth |
First Address | La Quinta, CA 92253-8300 |
Second Address | La Quinta, CA 92253-7245 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2013 |
Last Update Date | 08/07/2017 |