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Individual

MARK DAVID SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7695 CARDINAL CT STE 100, SAN DIEGO, CA 92123-3357
(858) 609-7100
(858) 609-7106
Mailing address
7695 CARDINAL CT STE 100, SAN DIEGO, CA 92123-3357
(858) 609-7100
(858) 609-7106

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
G55641
CA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
G55641
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G556410
CA
Enumeration date
12/06/2006
Last updated
11/10/2022
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