Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | 299674 | CA |
Y | 213ES0000X | Sports Medicine | 299674 | CA |
NPI | 1427648542 |
---|---|
Provider Name | Tyler Schnorf |
First Address | Santa Maria, CA 93454-7295 |
Second Address | Santa Maria, CA 93454-7295 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2021 |
Last Update Date | 22/01/2021 |