Individual
CHARLES RAYMOND SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10666 N TORREY PINES RD, LA JOLLA, CA 92037-1027
(858) 554-8799
Mailing address
FILE # 54433, LOS ANGELES, CA 90074-0001
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
145248
NY
2084N0400X
Neurology Physician
Primary
G87897
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00991617
—
NY
Enumeration date
11/17/2006
Last updated
06/29/2009
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