Provider Demographics
NPI:1801897467
Name:SCHMIDT, TIMOTHY (MD)
Entity type:Individual
Prefix:
First Name:TIMOTHY
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 1:18080 IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-3436
Mailing Address - Country:US
Mailing Address - Phone:714-746-7473
Mailing Address - Fax:
Practice Address - Street 1:275 BATTERY ST STE 650
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-3332
Practice Address - Country:US
Practice Address - Phone:800-997-6196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2015-0902207Q00000X
AZ51255207Q00000X
KS04-38541207Q00000X
HI18501207Q00000X
MTMED-PHYS-LIC-58030207Q00000X
MDD0080439207Q00000X
UT9511618-1205207Q00000X
NV16147207Q00000X
WI64990-20207Q00000X
IN01076230A207Q00000X
AK119238207Q00000X
ORMD1809058207Q00000X
CODR.0057991207Q00000X
WAMD00028215207Q00000X
CAG48045207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA50906Medicare UPIN
CAWG48045CMedicare PIN