Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | G62430 | CA |
NPI | 1942360755 |
---|---|
Provider Name | J Randolph Schnitman |
First Address | Beverly Hills, CA 90210 |
Second Address | Beverly Hills, CA 90210-4321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 08/07/2007 |