Individual
DR. EDEN LOWELL SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
680 GUZZI LN, STE 201, SONORA, CA 95370-5288
(209) 536-1785
(209) 536-1607
Mailing address
680 GUZZI LN, SUITE 201, SONORA, CA 95370-5288
(209) 536-1785
(209) 536-1607
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G19148
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G191480
—
CA
Enumeration date
06/10/2006
Last updated
07/08/2007
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