Provider Demographics
NPI:1992747489
Name:SCHNARE, BRIAN R (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:R
Last Name:SCHNARE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1980 SEQUOIA AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3167
Mailing Address - Country:US
Mailing Address - Phone:805-583-5555
Mailing Address - Fax:805-583-5637
Practice Address - Street 1:1980 SEQUOIA AVE
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-3167
Practice Address - Country:US
Practice Address - Phone:805-583-5555
Practice Address - Fax:805-583-5637
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC42414207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC42414OtherMEDICAL LIC.#
CAB26256Medicare UPIN