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Individual
MR. JARED W SMITH
Active
Individual
MR. JARED W SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA17095
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00126903
RAILROAD MEDICARE
CA
05
—
PA17095
—
CA
Enumeration date
06/30/2006
Last updated
08/02/2016
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