Provider Demographics
NPI:1316102387
Name:DAVID B. CIMINSKI, O.D.
Entity type:Organization
Organization Name:DAVID B. CIMINSKI, O.D.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:CIMINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:714-532-4900
Mailing Address - Street 1:1110 E CHAPMAN AVE
Mailing Address - Street 2:SUITE#107
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-2139
Mailing Address - Country:US
Mailing Address - Phone:714-532-4900
Mailing Address - Fax:714-532-4994
Practice Address - Street 1:1110 E CHAPMAN AVE
Practice Address - Street 2:SUITE#107
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2139
Practice Address - Country:US
Practice Address - Phone:714-532-4900
Practice Address - Fax:714-532-4994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-18
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8949152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU11650Medicare UPIN