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Individual

KENNETH PAUL SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5189 HOSPITAL RD, MARIPOSA, CA 95338-9524
(209) 966-3631
(209) 966-8438
Mailing address
PO BOX 951, LOS BANOS, CA 93635-0951
(209) 617-3721
(209) 966-8438

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
G68554
CA

Other

Enumeration date
09/27/2006
Last updated
05/29/2024
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