Provider Demographics
NPI:1952568321
Name:SCHMITT, ROBERT LARRY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LARRY
Last Name:SCHMITT
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 1:4017 RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-1712
Mailing Address - Country:US
Mailing Address - Phone:619-295-3535
Mailing Address - Fax:619-297-4771
Practice Address - Street 1:4017 RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-1712
Practice Address - Country:US
Practice Address - Phone:619-295-3535
Practice Address - Fax:619-297-4771
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2020-02-13
Deactivation Date:2009-08-31
Deactivation Code:
Reactivation Date:2020-02-13
Provider Licenses
StateLicense IDTaxonomies
CACFE310032084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry