Provider Demographics
NPI:1427117258
Name:ORINDA UROLOGY, INC.
Entity type:Organization
Organization Name:ORINDA UROLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-253-1470
Mailing Address - Street 1:9 SLEEPY HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-1320
Mailing Address - Country:US
Mailing Address - Phone:925-253-1470
Mailing Address - Fax:
Practice Address - Street 1:25 ORINDA WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-4403
Practice Address - Country:US
Practice Address - Phone:925-253-1650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG51425208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA51989Medicare UPIN