Provider Demographics
NPI:1063419273
Name:SCHNEIDER, JESSICA LYNN (MD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8631 W 3RD ST
Mailing Address - Street 2:SUITE 510E
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5901
Mailing Address - Country:US
Mailing Address - Phone:310-659-9104
Mailing Address - Fax:310-659-3049
Practice Address - Street 1:10309 SANTA MONICA BLVD
Practice Address - Street 2:# 300
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5007
Practice Address - Country:US
Practice Address - Phone:310-557-3766
Practice Address - Fax:310-282-8567
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2011-04-28
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Provider Licenses
StateLicense IDTaxonomies
CAA67526207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H67711Medicare UPIN