Provider Demographics
NPI:1821557786
Name:SCHMIDT, BENJAMIN (MD)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 ADDISON ST STE 329
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1192
Mailing Address - Country:US
Mailing Address - Phone:510-666-0854
Mailing Address - Fax:510-666-1192
Practice Address - Street 1:2001 ADDISON ST STE 329
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94704-1192
Practice Address - Country:US
Practice Address - Phone:510-666-0854
Practice Address - Fax:510-666-1192
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-19
Last Update Date:2023-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA180824207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology