Individual
JUSTIN R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1774 ZONAL AVE BLDG C, LOS ANGELES, CA 90033-1064
(310) 221-6336
Mailing address
108 W VICTORIA ST, GARDENA, CA 90248-3523
(310) 715-2020
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/08/2026
Last updated
01/15/2026
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