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Individual

DR. KENNETH E SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
20126 STANTON AVE, SUITE 205, CASTRO VALLEY, CA 94546-5271
(510) 537-4211
(510) 537-3345
Mailing address
20126 STANTON AVE, SUITE 205, CASTRO VALLEY, CA 94546-5271
(510) 537-4211
(510) 537-3345

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU2576
KS
237700000X
Hearing Instrument Specialist
HTL8430
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
640002892
RAILROAD MEDICARE
KS
Enumeration date
12/12/2005
Last updated
10/31/2012
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