Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | G68552 | CA |
NPI | 1063632636 |
---|---|
Provider Name | Dr. Diane L. Schneider |
First Address | Las Vegas, NV 89103-2010 |
Second Address | La Jolla, CA 92037-7643 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 14/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D46252 | (02) | CA |