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Individual

CAROLYN ANN SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
1551 BISHOP ST, 220, SAN LUIS OBISPO, CA 93401-4635
(805) 541-0668
(805) 541-8213
Mailing address
101 E REDLANDS BLVD, 212, REDLANDS, CA 92373-4775
(909) 335-8649
(909) 335-1994

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA14769
CA

Other

Enumeration date
05/30/2007
Last updated
09/09/2010
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