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Individual

DR. STACY R. SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
561 SAXONY PL, SUITE 102, ENCINITAS, CA 92024-7700
(760) 203-3839
(760) 203-3840
Mailing address
561 SAXONY PL, SUITE 102, ENCINITAS, CA 92024-7700
(760) 203-3839
(760) 203-3840

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G65407
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G65407
MEDICAL LICENSE
CA
Enumeration date
03/08/2006
Last updated
10/29/2013
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