Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | G52382 | CA |
NPI | 1265416655 |
---|---|
Provider Name | Dr. Philip Dana Schneider |
First Address | Sacramento, CA 95817-2229 |
Second Address | Sacramento, CA 95817-2229 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A52245 | (02) | CA |
G52382 | CA MEDICAL LICENSE (01) | CA |