Individual
BRIAN FREDERICK SCHMIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1701 4TH ST, STE 200, SANTA ROSA, CA 95404-3601
(707) 579-2100
(707) 523-0616
Mailing address
3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3634
(707) 525-6485
(707) 523-0616
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G52429
CA
2086S0127X
Trauma Surgery Physician
G52429
CA
2086S0129X
Vascular Surgery Physician
G52429
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G524290
BLUE SHIELD OF CALIFORNIA
CA
05
—
1275614596
—
CA
01
—
P00469232
RAILROAD MEDICARE
CA
Enumeration date
10/17/2006
Last updated
11/10/2021
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