Individual
RYAN GREGORY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 N 13TH AVE, UPLAND, CA 91786-4904
(909) 277-2420
(909) 206-1097
Mailing address
555 N 13TH AVE, UPLAND, CA 91786-4904
(909) 277-2420
(909) 206-1097
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A144479
CA
207W00000X
Ophthalmology Physician
C1-0025611
DE
207WX0120X
Cornea and External Diseases Specialist Physician
A144479
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164809851
NPI
CA
01
—
C1-0025611
MD LICENSE
DE
Enumeration date
05/01/2015
Last updated
07/24/2023
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