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Individual

DR. ERIC DAVID SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3301 EL CAMINO REAL STE 100, ATHERTON, CA 94027-3803
(650) 364-3080
(650) 364-2004
Mailing address
PO BOX 6102, NOVATO, CA 94948-6102
(415) 884-3418
(415) 883-8082

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A68606
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A686060
CA
01
0212626
L&I
WA
05
08255024
CO
05
1376599191
NV
01
300134148
RAILROAD MEDICARE
WA
01
300134150
RAILROAD MEDICARE
CA
01
5578SM
REGENCE BLUE SHIELD
WA
01
8905618
L&I; CVCP
WA
05
912841
AZ
05
9413833
WA
Enumeration date
05/25/2006
Last updated
04/21/2021
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