Provider Demographics
NPI:1396832341
Name:CIMINSKI, DAVID B (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:CIMINSKI
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 1:1110 E CHAPMAN AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-2139
Mailing Address - Country:US
Mailing Address - Phone:714-532-4900
Mailing Address - Fax:714-532-4994
Practice Address - Street 1:1110 E CHAPMAN AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2139
Practice Address - Country:US
Practice Address - Phone:714-532-4900
Practice Address - Fax:714-532-4994
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-09
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8949T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0089490Medicaid
CAU11650Medicare UPIN
CASD0089490Medicaid