Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A99407 | CA |
N | 207ND0900X | Dermatopathologist | A99407 | CA |
N | 207NS0135X | Procedural Dermatology | A99407 | CA |
NPI | 1053579979 |
---|---|
Provider Name | Ashley Ann Smith |
First Address | San Francisco, CA 94147-2590 |
Second Address | Sausalito, CA 94965-2800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2008 |
Last Update Date | 30/04/2013 |