Provider Demographics
NPI:1649277088
Name:SCHINKE, STANLEY D (MD)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:D
Last Name:SCHINKE
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 1:42125 CREST DR
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92544-8400
Mailing Address - Country:US
Mailing Address - Phone:951-658-1224
Mailing Address - Fax:
Practice Address - Street 1:301 N SAN JACINTO ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-3113
Practice Address - Country:US
Practice Address - Phone:951-766-6460
Practice Address - Fax:951-766-6459
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG55989174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1558555938OtherMEDICARE PART B DME
CAG55989OtherLICENSE
CA00G559890Medicaid
CA05D1062719OtherCLIA NUMBER
CA5945420004OtherMEDICARE PART D DME
CA1457545840OtherMEDICARE PART B DME
CA1639109457OtherGROUP NPI
CA5945420001OtherMEDICARE PART D DME
CA5945420002OtherMEDICARE PART D DME
CA5945420003OtherMEDICARE PART D DME
CA1225222029OtherMEDICARE PART B DME
CA1962696344OtherMEDICARE PART B DME
CA5945420003OtherMEDICARE PART D DME
CAG55989OtherLICENSE
CA1225222029OtherMEDICARE PART B DME