Provider Demographics
NPI:1962574947
Name:SCHNEIDER, MARTIN DAVID (PT)
Entity type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:DAVID
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4041 LONE TREE WAY # 106
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-6200
Mailing Address - Country:US
Mailing Address - Phone:925-754-6262
Mailing Address - Fax:925-754-2198
Practice Address - Street 1:4041 LONE TREE WAY
Practice Address - Street 2:SUITE 1064
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-6200
Practice Address - Country:US
Practice Address - Phone:925-754-6262
Practice Address - Fax:925-754-2198
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT11751225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist