Provider Demographics
NPI:1366432387
Name:SCHYMEINSKY, DAVID (OD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SCHYMEINSKY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:462 E CALAVERAS BLVD
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-5412
Mailing Address - Country:US
Mailing Address - Phone:408-262-4178
Mailing Address - Fax:408-262-5351
Practice Address - Street 1:462 E CALAVERAS BLVD
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-5412
Practice Address - Country:US
Practice Address - Phone:408-262-4178
Practice Address - Fax:408-262-5351
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 10094 TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0100940Medicaid
CASD0100940Medicaid
SD0100940Medicare ID - Type Unspecified