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Individual

MARK A. SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
101 THE CITY DR S, ORANGE, CA 92868-3201
(714) 456-8000
(855) 211-3729
Mailing address
1100 N PALM CANYON DR, SUITE 211, PALM SPRINGS, CA 92262-4414
(760) 320-9019
(760) 320-9685

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
00G470110
CA
2086S0129X
Vascular Surgery Physician
Primary
G47011
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
G470110
CA
Enumeration date
09/25/2006
Last updated
06/09/2025
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