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General NPI Number Information
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NPI Number | 1346467891
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Entity Type | Individual
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Provider Name | RUSSELL STANFORD SCHMIDT OD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 06/07/2010
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Provider Practice Location Address
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Address Line | 4710 N CEDAR AVE SUITE 102
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City | FRESNO
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State | CA
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Zip | 93726-1086
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Country | US
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Telephone | 559-225-0150
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Fax | 559-299-4763
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Provider Business Mailing Address
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Address Line | 5661 N ANGUS ST
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City | FRESNO
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State | CA
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Zip | 93710-6112
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Country | US
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Telephone | 559-439-9727
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Fax | 559-229-4763
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT5596
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License Number State | CA
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