Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 34024 | CA |
NPI | 1134223480 |
---|---|
Provider Name | Dr. Hugo Victor Schmidt III |
First Address | Greenbrae, CA 94904 |
Second Address | Greenbrae, CA 94904-2024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2006 |
Last Update Date | 08/07/2007 |