Active NPI
Gary Gene Schwab, O.D.
- Optometrist
- San Diego, CA
National Provider Identifier
1740274372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 7571 T
- Practice address
- 3670 Clairemont Drive
Suite 1
San Diego, CA 92117-5958 - Phone
- (858) 274-2020
- Fax
- (858) 274-2090
- NPI assigned
- Sep 9, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 7571 T | CA | Primary |
Addresses
Primary practice location
3670 Clairemont Drive
Suite 1
San Diego, CA 92117-5958
Mailing address
3670 Clairemont Drive
Suite 1
San Diego, CA 92117-5958
Phone (858) 274-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SD0075710 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180615001719 | CA | Order and Referring Only - Optometry | 1658305305 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7571 T | CA | MD | Optometrist |
| 7571 | CA | MD | Speech-Language Assistant |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247443200000",
"number": "1740274372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3670 CLAIREMONT DRIVE",
"address_2": "SUITE 1",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921175958",
"telephone_number": "858-274-2020",
"fax_number": "858-274-2090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3670 CLAIREMONT DRIVE",
"address_2": "SUITE 1",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921175958",
"telephone_number": "858-274-2020",
"fax_number": "858-274-2090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHWAB",
"first_name": "GARY",
"middle_name": "GENE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-09",
"last_updated": "2009-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "7571 T",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0075710",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.