Provider Demographics
NPI:1356353825
Name:SCHMIDT, JOSEPH DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:DAVID
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:200 W ARBOR DRIVE
Mailing Address - Street 2:MAIL CODE 8897
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-8897
Mailing Address - Country:US
Mailing Address - Phone:619-543-2628
Mailing Address - Fax:619-543-6573
Practice Address - Street 1:200 W ARBOR DR
Practice Address - Street 2:MAIL CODE 8897
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-9001
Practice Address - Country:US
Practice Address - Phone:619-543-2628
Practice Address - Fax:619-543-6573
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG31767208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G317670Medicaid
CAWG31767AMedicare ID - Type Unspecified
CAA44862Medicare UPIN