Healthcare Provider Details

I. General information

NPI: 1720472616
Provider Name (Legal Business Name): RYAN J SCHMITT PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2015
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34800 BOB WILSON DR BLDG 3 CARDIOLOGY
SAN DIEGO CA
92134-1700
US

IV. Provider business mailing address

10556 DARWELL CT
SAN DIEGO CA
92126-3035
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-7400
  • Fax: 619-532-9863
Mailing address:
  • Phone: 858-229-9532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA-52288
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number52288
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: