Provider Demographics
NPI:1700884863
Name:SCHEININ D P M A PROFESSIONAL CORPO, GARY STEVEN
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:STEVEN
Last Name:SCHEININ D P M A PROFESSIONAL CORPO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 E HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-0266
Mailing Address - Country:US
Mailing Address - Phone:408-378-5887
Mailing Address - Fax:
Practice Address - Street 1:131 E HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-0266
Practice Address - Country:US
Practice Address - Phone:408-378-5887
Practice Address - Fax:408-379-2672
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2146213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT11199Medicare UPIN
CA0642230001Medicare NSC