Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 65229 | WI |
N | 208000000X | Pediatrician | A132700 | CA |
Y | 2080P0204X | Pediatric Emergency Doctor | A132700 | CA |
NPI | 1073951828 |
---|---|
Provider Name | Stephanie Schroter |
First Address | San Diego, CA 92123-4223 |
Second Address | San Diego, CA 92123-4223 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2013 |
Last Update Date | 10/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1073951828 | (05) | WI |