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Individual

DR. VANCE LA BARON SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
300 BERRY ST, UNIT 817, SAN FRANCISCO, CA 94158-1593
(614) 313-3444
Mailing address
300 BERRY ST, UNIT 817, SAN FRANCISCO, CA 94158-1593
(614) 313-3444

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
57-007911
OH
208600000X
Surgery Physician
Primary
A111926
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
COAAA1467
CO
05
EA834A
CA
Enumeration date
05/10/2007
Last updated
10/25/2013
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