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Organization
RICHARD C. SMITH, M.D. A PROFESSIONAL CORPORATION
Active
Organization
RICHARD C. SMITH, M.D. A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD CHARLES SMITH M.D. (PRES.)
(310) 833-2428
Entity
Organization
Contact information
Practice address
1350 W 6TH ST, SUITE 2, SAN PEDRO, CA 90732-3544
(310) 833-2428
(310) 833-7850
Mailing address
1350 W 6TH ST, SUITE 2, SAN PEDRO, CA 90732-3544
(310) 833-2428
(310) 833-7850
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C31822
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C318220
—
CA
01
—
1801857453
INDIVIDUAL NPI
CA
05
—
7993517
—
CA
01
—
C31822
LICENSE
CA
01
—
WC31822B
MEDICARE PPIN
CA
Enumeration date
02/01/2007
Last updated
12/11/2007
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