Individual
DUSTIN D SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11234 ANDERSON ST, LOMA LINDA, CA 92354-2804
(909) 558-4344
Mailing address
54701 FILE NUMBER, LOS ANGELES, CA 90074-4701
(909) 558-3111
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A69555
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A695550
—
CA
Enumeration date
07/19/2006
Last updated
07/08/2007
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