Individual
THOMAS E SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
425 W BONITA AVE STE 110, SAN DIMAS, CA 91773-2543
(909) 599-0981
(909) 592-0738
Mailing address
425 W BONITA AVE STE 110, SAN DIMAS, CA 91773-2543
(909) 599-0981
(909) 592-0738
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E2504
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E25040
—
CA
05
—
000E25041
—
CA
01
—
480002990
PALMETTO GBA
CA
01
—
480012426
PALMETTO GBA
CA
Enumeration date
07/12/2006
Last updated
05/13/2008
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