Basic Information
Provider Information
NPI: 1790768679
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHROT
FirstName: RUDOLPH
MiddleName: J.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SCHROT
OtherFirstName: RUDOLPH
OtherMiddleName: J.
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 2
Mailing Information
Address1: 10470 OLD PLACERVILLE RD
Address2: SUITE 100
City: SACRAMENTO
State: CA
PostalCode: 958272539
CountryCode: US
TelephoneNumber: 8004700071
FaxNumber:  
Practice Location
Address1: 2800 L ST
Address2: SUITE 500
City: SACRAMENTO
State: CA
PostalCode: 958165616
CountryCode: US
TelephoneNumber: 9164546850
FaxNumber: 9164546852
Other Information
ProviderEnumerationDate: 11/23/2005
LastUpdateDate: 06/29/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207T00000XA70871CAY Allopathic & Osteopathic PhysiciansNeurological Surgery 

No ID Information.


Home