Individual
DR. WADE MICHAEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1601 AVOCADO AVE, NEWPORT BEACH, CA 92660-7798
(949) 763-2204
Mailing address
PO BOX 512185, LOS ANGELES, CA 90051-0185
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
A93190
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A93190
STATE LICENSE
CA
Enumeration date
12/12/2006
Last updated
12/02/2020
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