Individual
DWIGHT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
165 N LA BREA AVE, INGLEWOOD, CA 90301-1707
(323) 678-1111
Mailing address
165 N LA BREA AVE, INGLEWOOD, CA 90301-1707
(323) 678-1111
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
C37854
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C378540
—
CA
01
—
WC37854A
MEDICARE RENDERING NUMBER
CA
Enumeration date
02/17/2007
Last updated
02/15/2012
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