Individual
CASEY JAKE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2950 INTERNATIONAL BLVD, OAKLAND, CA 94601-2228
(505) 862-2029
Mailing address
1545 DIVISADERO ST STE 306, SAN FRANCISCO, CA 94143-3400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A189429
CA
Other
Enumeration date
04/11/2020
Last updated
09/19/2023
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