Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | G22835 | CA |
NPI | 1023011582 |
---|---|
Provider Name | Dr. Kimber Lee Schneider |
First Address | Colton, CA 92324-4614 |
Second Address | Colton, CA 92324-4614 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2005 |
Last Update Date | 22/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G228350 | (05) | CA |
00G228350 | BLUE CROSS (01) | CA |
A41741 | (02) | CA |