Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A141037 | CA |
N | 111NI0900X | Internist | A141037 | CA |
Y | 207RH0002X | Hospice and Palliative Medicine | A141037 | CA |
NPI | 1265851331 |
---|---|
Provider Name | Dr. Grant Matthew Smith |
First Address | Stanford, CA 94305-2200 |
Second Address | Stanford, CA 94305-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2014 |
Last Update Date | 24/11/2021 |