Individual
SUSANA INES SMITH HARBUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20101 LAKE CHABOT RD FL 4, CASTRO VALLEY, CA 94546
(510) 204-1844
(510) 506-7729
Mailing address
2350 W EL CAMINO REAL FL 2, MOUNTAIN VIEW, CA 94040-6203
(510) 204-1844
(510) 506-7729
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A136741
CA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
92819
GA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
A136741
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A136741
STATE MEDICAL LICENSE
CA
Enumeration date
04/09/2013
Last updated
03/07/2023
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