Individual
KELLY GHISLAINE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
160 E ARTESIA ST STE 330, POMONA, CA 91767-2922
(909) 622-5654
(909) 622-4914
Mailing address
160 E ARTESIA ST STE 330, POMONA, CA 91767-2922
(909) 622-5654
(909) 622-4914
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A172901
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2017
Last updated
07/22/2021
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