Provider Demographics
NPI:1104018209
Name:DAVID W. STEMLEY, O.D., INC.
Entity Type:Organization
Organization Name:DAVID W. STEMLEY, O.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:STEMLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:760-729-9353
Mailing Address - Street 1:2540 EL CAMINO REAL STE B
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1286
Mailing Address - Country:US
Mailing Address - Phone:760-729-9353
Mailing Address - Fax:760-729-0583
Practice Address - Street 1:2540 EL CAMINO REAL STE B
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1286
Practice Address - Country:US
Practice Address - Phone:760-729-9353
Practice Address - Fax:760-729-0583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7067T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT70171OtherUPIN
CA0155580001Medicare NSC
CAAP857Medicare PIN