Individual
DONALD T SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5974 PENTZ RD, PARADISE, CA 95969-5509
(530) 877-4649
Mailing address
PO BOX 385, PARADISE, CA 95967-0385
(530) 877-4649
(530) 877-4649
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
G24169
CA
208600000X
Surgery Physician
Primary
G24169
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
CA
01
—
ZZZ01920Z
BLUE SHIELD
CA
Enumeration date
07/26/2006
Last updated
09/12/2011
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