Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | A121605 | CA |
NPI | 1083863716 |
---|---|
Provider Name | Dr. Kevin M Smith |
First Address | Encinitas, CA 92023-1189 |
Second Address | Encinitas, CA 92024-5142 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2008 |
Last Update Date | 16/02/2017 |