Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | A106806 | CA |
NPI | 1558595215 |
---|---|
Provider Name | Dr. Michael Andrew Smit |
First Address | Providence, RI 02903-4923 |
Second Address | Los Angeles, CA 90027-6062 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2009 |
Last Update Date | 24/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A106806 | LICENSE (01) | CA |