Provider Demographics
NPI:1386843399
Name:WILLIAM R SCHMITT, MD, INC
Entity Type:Organization
Organization Name:WILLIAM R SCHMITT, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALER, BILLER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CANIFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-322-3166
Mailing Address - Street 1:1100 N PALM CANYON DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4414
Mailing Address - Country:US
Mailing Address - Phone:760-322-3166
Mailing Address - Fax:760-322-9309
Practice Address - Street 1:1100 N PALM CANYON DR
Practice Address - Street 2:SUITE 107
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4414
Practice Address - Country:US
Practice Address - Phone:760-322-3166
Practice Address - Fax:760-322-9309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG37914207V00000X, 207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ50078YOtherBLUE SHIELD
CA00A978690Medicaid
CA00G379140Medicaid
CAGR0105270Medicaid
CA00A978690Medicare PIN
CA00A978690Medicaid
CAGR0105270Medicaid